Other Voices

Texas Legislature seeks only to unshackle optometrists, enhance patient care

Visitors and guests line up in the rotunda of the Texas State Capitol to enter the House Chamber for the beginning of the 86th Texas Legislative session, Tuesday, Jan. 8, 2019, in Austin.
Visitors and guests line up in the rotunda of the Texas State Capitol to enter the House Chamber for the beginning of the 86th Texas Legislative session, Tuesday, Jan. 8, 2019, in Austin. AP

It will be a great day for patients when Doctors of Medicine (physicians) recognize Doctors of Optometry (optometrists) for what they are – experts in eye care that handle the vast majority of Texans’ eye care needs.

It will also be a great day when physicians put patients ahead of politics, and extend the hand of collegiality to optometrists to maximize their impact within the health care system, as opposed to attacking good legislation for patients, such as HB 1798.

On Thursday, an op-ed ran in this same space titled “Why can’t Texas legislature see the danger in allowing eye surgery without this?” The answer to this is simple – there is no danger to see.

Optometrists have been caring for eye disease for almost 30 years, and are held to the exact same standard of care as ophthalmologists.

Readers were subjected to much hyperbole and two broad mischaracterizations, the first being what HB 1798 actually does if it becomes law, and second the training and sophistication of Doctors of Optometry.

HB 1798 modernizes the Texas Optometry Act in several important ways to bring better, timely eye care to patients at a lower cost to patients and insurers.

First, the bill removes old restrictions on the types of medication optometrists can use to treat your eye problem. Optometrists already prescribe and use topical and oral medications, but with outdated restrictions and erroneous limitations on the amount and duration.

Optometrists are well-trained on the use and effects of prescription medications, and limiting their ability to prescribe at the time the problem is occurring serves only to hurt patients’ access to convenient, quality care.

Second, the bill removes extraordinarily unnecessary restrictions on optometrists’ ability to provide patients with direct glaucoma care. Optometrists already diagnose, treat and manage glaucoma. But because of outdated state law, Texas patients with glaucoma are required to have a mandatory second opinion from another provider once diagnosed, which is costly, inefficient and unnecessary.

Third, the bill allows optometrists to provide minor, in-office surgical procedures that do not require a hospital setting or general anesthesia. This will allow your optometrist to help you at the time of your problem, instead of waiting weeks or months to have a small procedure performed by someone else.

Optometrists already perform minor surgical procedures on the eyes, but once again are limited in what we can provide patients to less than our education and training.

Doctors of Optometry obtain a four-year Bachelor’s Degree and then a four-year Doctorate Degree, very similar to the dental education model. During that time, all facets of pharmacology, ocular and systemic disease and treatment options, including minor surgeries, are studied and practiced.

Optometrists then must pass a three-part, multi-year national board examination in order to be licensed.

It’s important to note that HB 1798 purposely and thoughtfully excludes major, invasive eye surgeries that ophthalmologists perform, such as cataract surgery, retinal surgery and LASIK. These are procedures that ophthalmologists should continue to be the sole provider for.

The aim of HB 1798 is to clearly delineate services that need to be performed in the operating room versus those tasks that are performed in the doctor’s office, and by whom.

HB 1798 takes the handcuffs off our highly-trained Doctors of Optometry, so that Texas patients can be better served, and health care efficiency can be improved.

To help overcome the unfortunate, politically-motivated scare tactics from physicians, please visit www.focustexas.org to learn more and sign a petition to Texas lawmakers.

Jenny Terrell is an optometrist with the Community Eye Clinic in Fort Worth.
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