Ophthalmologists are cautioning provincial governments against advancing proposals that would permit optometrists to conduct certain surgeries and laser eye treatments that currently fall outside their authorized duties.
Dr. Nina Ahuja, the incoming president of the Canadian Ophthalmological Society, emphasizes the necessity for surgery to remain under the purview of medical doctors. She asserts that delegating even seemingly minor procedures to optometrists poses a significant risk to patient safety.
This response follows reports that the governments of Ontario and Alberta are collaborating with optometrists to introduce changes to their practice. While both professions focus on eye care, optometrists serve as primary eye care providers with a four-year professional degree following undergraduate studies, while ophthalmologists are specialized surgeons and eye disease experts with a minimum of nine years of medical training post-undergrad.
Drawing from her extensive experience of over two decades in ophthalmology, Ahuja highlights that surgical expertise involves more than technical skills; it necessitates a comprehensive understanding of the body’s functioning and the importance of a patient’s medical background.
She analogizes the roles of an optometrist and an ophthalmologist to those of an air traffic controller and a pilot respectively, underscoring the distinct skill sets required. Ahuja emphasizes the critical importance of entrusting surgical procedures to highly trained professionals.
In Ontario, a spokesperson for the health minister indicates that the proposed changes could empower optometrists to conduct minor in-office surgical procedures under local anesthesia, administer laser therapy for managing cataracts and glaucoma, order diagnostic tests, and independently treat open-angle glaucoma.
While the suggested changes do not encompass surgeries for cataracts, vitreoretinal issues, or strabismus, the objective is to alleviate the burden on medical professionals and hospitals offering such services by expanding optometrists’ responsibilities.
The Alberta College of Optometrists proposed broadening their scope of practice in 2020 to include minor laser treatments, injections, and superficial skin surgical procedures like removing skin tags and warts. Alberta’s Ministry of Primary and Preventative Health Services has expressed support for this expansion and is currently collaborating with the optometrists’ college to finalize the proposed modifications.
Optometrists seeking to undertake these procedures would need to pass examinations on laser techniques and minor surgeries and undergo supervised clinical practice to ensure proficiency. The ministry acknowledges the college’s willingness to refine its proposals to address patient safety concerns, although specific details on these adjustments remain undisclosed.
Dr. Allison Scott, president of the Canadian Association of Optometrists, reassures that the proposed changes do not encompass surgeries requiring an operating room, such as retinal procedures. She points to data from the U.K. and U.S., where optometrists are authorized to perform laser procedures, demonstrating the safety and efficacy of such practices.
Scott emphasizes that optometry students are well-versed in the proposed procedures, potential complications, and how to manage them safely. She highlights the rigorous training programs that equip optometrists with the necessary skills to ensure patient safety.
Overall, the debate surrounding the expansion of optometrists’ responsibilities in eye care continues, with stakeholders emphasizing patient safety and the need for thorough training and oversight to maintain high standards of care.