Thursday, October 24th, 2024

Dear Ms. Moss:

As a member of the Virginia Society of Eye Physicians and Surgeons, I write to you today to express my deep concern regarding the particular section in the draft regulations regarding proctoring for those individuals seeking certification for laser eye surgery.

As the Board of Optometry finalizes the regulations for laser surgery certification, I strongly recommend amending the draft regulations to reflect a proctoring process that requires both didactic and live proctored cases, whether or not a plastic model is involved. Currently, the draft regulations are written so that proctoring can be done on a model eye or on a live patient, and in some cases proctoring is not even required.

There is quite a bit of difference between doing laser cases when there is a clear model eye and the variety of patient's presentations.  There are many potential complications that a model eye or one or two proctored cases will not encompass.  A doctor should perform at least 20 to 30 proctored cases to feel somewhat comfortable with a laser procedure.  Also, the doctor should see a wide variety of cases.  The requirements to be certified will not be sufficient for someone to feel comfortable going solo on a laser procedure on a live patient.  

There is a wide spread list of physiological issues that can affect individuals’ ability to remain still during a laser eye surgery procedure. Some examples of these varying factors can include, but are not limited to, tremors, anxiety, or breathing movements particularly for obese patients. The smallest movement of the patient’s eye, even a centimeter, can result in dangerous and detrimental outcomes for the patient because laser eye surgery treatment is measured in the sphere of microns.

This request comes with patient safety as the top priority and ensuring quality, safe care is provided throughout the Commonwealth. I strongly hope you will consider this change to the draft regulations to ensure optometrists across the state are trained to the highest standard.

Sincerely,

Philip Chung, MD