California legislators protect patient safety by rejecting creation of Optometric Surgeons

Huge “Win” for Patient Safety in California

A bill that would have allowed optometrists to perform surgery, SB 1406, has been severely limited by amendments to allow only changes to the process by which optometrists are certified to treat glaucoma, certain non-surgical procedures and testing, and some additions to the limited formulary they are permitted to prescribe, as well as other minor changes.

Thanks to strong work on the part of a coalition of CAEPS, the California Medical Association (CMA), the American Academy of Ophthalmology (AAO), and the California Educators of Ophthalmology for Quality Care (Department Chairs of California university training programs), patient safety has come first in this process. The coalition was a formidable obstacle to organized optometry, forcing them to come to the table and negotiate.

Without our efforts, the bill could have let optometrists:

  • Perform ALL EYE SURGERY;
  • Perform injections, likely including intravitreal injections;
  • Order ANY Diagnostic Test; and
  • Treat nearly ALL types of glaucoma after only graduation from optometry school (or very limited undefined additional training).

In addition, the meaningless “oversight” mechanism originally proposed to “comment” on standards for the revised glaucoma certification process has been significantly strengthened to require the Board of Optometry to adopt the committee’s recommendations (subject to amendment by the Office of Examination Resources to meet certain standards), and the nominees of CAEPS and the CMA must occupy the physician and surgeon positions on the committee, which make up half the appointments.

As with any negotiation process, certain other things like additions to the formulary, some diagnostic testing, various modifications of referral requirements, and minor non-surgical procedures were authorized without specific educational standards. CAEPS will, however, work with the Board of Optometry to attempt to establish such standards through the regulatory process.

Because of the changes to the bill, all the involved groups have dropped their opposition to the legislation, which has now passed both the Assembly and the Senate and is awaiting the Governor’s signature.