Firstly, I would like to respectfully point out the misleading way in which MD’s are framing the procedures outlined in these regulations. Many are using the term laser “surgery” to make these procedures seem highly invasive and complicated. However, in a majority of ophthalmologic literature, MD’s cite lasers as relatively quick, simplistic outpatient “procedures”. Unsurprisingly, it seems MD’s would like these laser procedures to sound more complicated and invasive when it suits their agenda. 

Secondly, patients and MD’s have rightfully brought up concerns about OD’s ability to handle potential complications from these laser procedures. I will link a recent article reporting the low prevalence of complications reported from laser procedures performed by OD’s. I will also link an article discussing further the more vision-threatening complications that can arise post-YAG procedure regardless of the title of the person firing the laser. A few of these include: retinal detachments, CME, and glaucoma. These conditions are certainly something OD’s would know how to identify and manage.

I would also like to address the supposed lack of training from OD’s to handle laser procedures. OD’s spend 4+ years extensively studying the eye and systemic health. Included in this curriculum is coursework and hands-on training for laser procedures. MD’s only start to learn laser procedures during residency, which is about 3-4 years. It’s not like they spend four years of med school PLUS residency learning these techniques. I would be curious to hear from MD’s about the amount of hours they spent practicing laser procedures before performing it on a live patient. 

While I agree that there are many OD’s that I would not trust to do a laser procedure on my family members, I could say the same for a handful of the MD’s I’ve worked with over the years. Inevitably, in any field, there are people who will not take safety or boundaries of their own knowledge into account.

At the end of the day, optometry is the backbone of ophthalmology. Together we make a beautiful spinal column. If MD’s want to continue to reap the benefits of having OD’s to give them referrals and $$$, but want to diminish their training and competence, neither of our professions are focusing on what’s best for the patient. Ultimately, OD’s and MD’s are meant to have a synergistic relationship, playing to each other’s strengths and weaknesses. Tearing each other down does nothing to further either of our fields. 

Expanded scope of practice is not meant to take opportunities away from MD’s. It’s meant to benefit the patient. 

Articles mentioned: 

https://www.reviewofoptometry.com/article/study-confirms-safety-of-optometric-laser-surgery

https://iovs.arvojournals.org/article.aspx?articleid=2787826

https://europe.ophthalmologytimes.com/view/yag-shots-in-iols-safe-or-dangerous-