The Massachusetts Medical Society wishes
to be recorded in opposition to the above referenced legislation which would expand
the scope of practice for optometrists by allowing them to treat glaucoma and
to prescribe oral therapeutic medications.
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 Massachusetts Medical
Society urges an “Ought Not to Pass” recommendation for H.1169, H.1174 and
H.2463.