The Massachusetts Medical Society wishes to be recorded in
opposition to the following bills that would expand the scope of practice for
optometrists by allowing them to treat glaucoma and to prescribe oral
therapeutic medications:
- H.1906, “An Act Ensuring Consumer
Choice and Equal Access to Eye Care” (Haddad)
- H.1923, “An Act Modernizing
Optometric Patient Care” (Jones)
- H.1924, “An Act Relative
to the Treatment of Glaucoma” (Jones)
- S.1239, “An Act Ensuring Consumer
Choice and Equal Access to Eye Care” (DiDomenico)
- S.1308, “An Act ensuring
consumer choice and equal access to eye care” (Moore)
The MMS also opposes H.1925, “An Act Studying the Impacts of
the Diagnosis Restrictions on Optometrists” (Jones). This bill would require the Department of
Public Health, the Department of Professional Licensure and the Board of
Registration in Optometry to produce a report on costs imposed on Massachusetts
residents from the current statutes that restrict optometrists from treating
glaucoma. Upon completion of the report, the bill would direct the DPH and
Board of Registration in Optometry to hold a public hearing and would then authorize
the Commissioner of Public Health to promulgate regulations to broaden the
scope of practice for optometrists.
Doctors of optometry are not medical doctors. Below are the
statutory requirements for licensure of optometrists (M.G.L.Chapter 112, Section 68):
“that he has graduated from a high
school having a course of study of four years and approved by the board or has
had a preliminary education equivalent to at least four years in public high
school, and that he has graduated from a school or college of optometry,
approved by the board, maintaining a course of study of not less than two years
with a minimum requirement of fifteen hundred attendance hours or in the case
of a person applying for a first examination after January first, nineteen hundred
and thirty-five, maintaining a course of study of not less than three separate
academic years, each academic year consisting of thirty-six weeks of classroom
work with thirty hours of instruction each week and this course of study shall
include ninety-five hours of study in the following areas:”
Compare the licensure requirements for optometrists and
ophthalmologists. Physicians have four
year undergraduate degrees, attend medical school for four years and complete
at least a one year internship. Physicians
who become ophthalmologists usually have a three year residency which follows
this internship and may have further years of subspecialty training. Ophthalmologists have between 12-16,000 total
patient care hours required through training, plus internship.
The difference in the length of study is important but the
subject matter is the real key.
Optometrists study the physical structure of the eye. They learn how to recognize deformities and
how to change the way light reaches the eyes as a means of compensating for
such deformities and defects. They are
taught to recognize that certain deformities and defects may indicate the
possible presence of disease. However, the statutory educational requirements
for licensing are worth a careful review.
The statute specifies the following requirements, among others: eight
hours in pharmacology, three of which shall be in pediatric pharmacology; and
ten hours in indications and ocular effects of commonly prescribed drugs, two
of which shall be in indications of effects in pediatric situations;…two hours
in pediatric eye diseases; two hours in glaucoma; and one hour in ocular
emergency.
The entire emphasis of optometry training is to ensure that
vision deficiencies are corrected through the use of corrective lenses. Optometrists change lenses, not the tissue of
the eyes. Optometry is a different
profession from the treatment of disease.
The prospect of optometrists treating disease through oral medications
or performing any form of surgery on the eye or the face is not warranted based
on the educational requirements for licensing listed above.
For these reasons the MMS urges
an “Ought Not to Pass” recommendation for H.1906, H.1923, H.1924, S.1239,
S1308, and H.1925.
