California ODs one step away from expanded scope that includes laser privileges
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Legislation recently passed by the California Assembly and Senate would allow optometrists in the state to use therapeutic lasers, remove lesions and perform corneal crosslinking.
AB 2236 awaits the signature of Gov. Gavin Newsom, who has until Sept. 30 to sign or veto the bill, California Optometric Association executive director Kristine Shultz told Healio.
According to Shultz, the new privileges would include selective laser trabeculoplasty, laser peripheral iridotomy for the prophylactic treatment of a clinically significant narrow drainage angle of the anterior chamber of the eye and laser posterior capsulotomy after cataract surgery.
Optometrists would also be permitted to excise or drain nonrecurrent and noncancerous lesions of the adnexa that do not involve the eyelid margin, lacrimal supply or drainage systems; are no deeper than the orbicularis muscle (except chalazia); and are smaller than 5 mm in diameter. In addition, the optometrist could administer local anesthesia to perform these procedures and close any resulting wounds. Injections for treatment of chalazia would also be allowed.
Lastly, the legislation would permit optometrists to administer medication and ultraviolet light to make corneal tissues stronger, a procedure known as corneal crosslinking.
Shultz said the new law would ensure patients have access to the care they need.
“In some counties, Medi-Cal patients must wait months to get in with an ophthalmologist,” she said. “Optometrists already provide 81% of the eye care under Medi-Cal and are located in almost every county in California. [They] are well-situated to bridge the provider gap for these eye conditions that are becoming more common as our population ages.”
The California Academy of Eye Physicians and Surgeons, the California Medical Association and several other medical associations posed strong opposition to this legislation, according to Shultz.
“They argued that optometrists should be allowed to perform the procedures but disagreed on the training that should be required,” she said. “The bill passed the last night of session with 10 minutes to spare.”
A June 25 letter from the executive vice president of the California Academy of Eye Physicians and Surgeons to the chair of the Senate Business Professions and Economic Development Committee, which Shultz provided to Healio, stated, “... that training requires sufficient experience to develop ‘surgical judgment’ and to be able to identify, avoid if possible, and manage and mitigate complications ...”
Shultz told Healio: “We think the governor will sign [the legislation into law] later in the month.”
Reference:
- AB 2236. Fast Democracy. https://fastdemocracy.com/bill-search/ca/20212022/bills/CAB00024692/. Updated Aug. 31, 2022. Accessed Sept. 6, 2022.
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