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Punctal occlusion privileges validated — in the best interest of patients
I’m sure many years from now we’ll look back upon it as just another “bump in the road.” A footnote in the legislative history of New York State optometry. But right now it seems like a pretty big deal. A reaffirmation for optometry. A validation of services provided to our patients.
The “it” is the New York Supreme Court Appellate Division’s summary judgment of Nov. 7 validating optometry’s privilege to perform nasolacrimal duct and lacrimal canaliculi probing as well as lacrimal punctum closure. For those of you unfamiliar with these proceedings, let me explain.
Practice scope clarified
In 1995 our state legislature redefined the practice of optometry, mainly to incorporate therapeutic prescribing privileges. Pursuant to this legislation, the New York State Optometric Association requested clarification on certain scope of practice issues, including those related to the lacrimal system. As the Department of Health was unable to obtain a consensus from optometry and ophthalmology, they deferred judgment to the State Education Department’s Office of Professions. The Office of Professions ultimately concluded that nasolacrimal duct probing, lacrimal canaliculi probing and lacrimal punctum closure were all within the scope of optometry.
In July 2000, a New York citizen — and ophthalmologist — commenced litigation to prevent Medicaid reimbursement for lacrimal procedures performed by optometrists. In exercising his legal right, the plaintiff contended that the aforementioned procedures were too “invasive” to be considered within the scope of optometry. Ultimately, the court ruled that only the Department of Health and the State Education Department possessed the knowledge and expertise necessary to make the correct decision. As a result, optometry retained the privilege to perform these services.
Please do not misconstrue the intent of this editorial. This isn’t about optometry vs. ophthalmology, and it certainly isn’t written in the spirit of gloating. Quite the contrary. I have far too much respect for ophthalmology and the numerous ophthalmologists I interact with on a daily basis. Rather, I write this editorial with gratitude.
Decision made on due diligence
I’m not naive enough to think that the court’s decision was made in a vacuum. Undoubtedly, the Department of Health and the State Education Department based their original decision on “due diligence.” In reviewing other states’ interpretations, it is evident that these procedures are often performed by optometrists throughout the country. For this, I thank the Department of Health and the State Education Department for their prudence.
Furthermore, this decision would have never been reached without the efforts (and vigilance) of the New York State Board of Optometry and the New York State Optometric Association. Without NYSOA’s leadership, officers and legal counsel, optometry has no collective voice.
Finally, I realize that there are two sides in every legal dispute and that decisions are not always easily made. However, based on the facts, the court issued a judgment that is in the best interest of the residents of New York. And, for this, we should all be thankful.