Bill halts expansion of optometric scope of practice in California

California Gov. Arnold Schwarzenegger has signed legislation that, in its original incarnation, would have permitted optometrists to perform ophthalmic surgeries and administer eye injections, the American Academy of Ophthalmology announced.

The bill, called SB 1406, now includes provisions that will curtail the scope of optometric expansion for treating glaucoma and will maintain patient referral safeguards, according to the AAO.

Under the legislation, optometrists will be authorized to diagnose and treat primary open-angle glaucoma, as well as exfoliation and pigmentary glaucoma. Optometrists will be required to refer patients with an attack of acute closed-angle glaucoma to an ophthalmologist for emergency stabilization.

In addition, the bill includes a mechanism for reviewing the standards of the revised glaucoma certification process. The review will be conducted by a six-member committee, of which three members will be nominated by the California Medical Association and California Academy of Eye Physicians and Surgeons. After a review by the state Office of Examination Resources, the California Board of Optometry will be required to implement the committee's findings, the AAO said.

As originally introduced, the bill would have authorized optometrists to perform all ophthalmic surgeries, administer eye injections, diagnose and treat all forms of glaucoma, and diagnose and treat ocular inflammation in children older than 12 years of age. In addition, the bill would have allowed optometrists to order any test or procedure required to diagnose and treat ophthalmic conditions and to diagnose or treat these conditions without being required to refer patients who do not improve to ophthalmologists.

"If the bill's original provisions had not been stopped, there would have been significant repercussions for patient safety in every other state," Cynthia Bradford, MD, AAO secretary for state affairs, said in a press release. "California is a bellwether state, and optometric expansion here would have led to an optometric scope expansion push in statehouses across the country."