Editor: I recently read a letter to the editor in this publication that struck a nerve. I am an optometrist who has practiced in Colorado for 22 years. I have carefully cared for the vision and eye health of thousands in my community and take that responsibility very seriously. The exploitation of one person’s tragic yet complicated case to try to scare the public is shameful.
The procedure described in the recent op-ed, a laser procedure for the treatment of floaters, is not one that would be included in a Colorado optometrist’s scope of practice or allowed by HB1233. While Charlotte’s story is very unfortunate, more than 100,000 laser procedures have been safely performed by optometrists in other states. HB1233 would only allow Colorado optometrists to perform procedures that are taught in all 24 optometry schools across the country and that are tested on their national board examinations. The procedure discussed in the previous op-ed would not meet these criteria.
Optometrists have a 4-year post-graduate, doctoral-level education that includes over 10,000 hours of rigorous didactic and experiential clinical education. Curricula for medical school and optometry school share many of the same courses and require the same prerequisites. Many optometrists choose to further their education in the form of a residency for additional experience or to sub-specialize. This training is most comparable to a dentist or podiatrist, both of which perform many more complex procedures than what is being considered in HB1233. While our education is far from insignificant or inadequate, we do not do advanced surgical procedures requiring an operating room, sedation, or general anesthesia. We leave cataract surgery, refractive surgery (LASIK/PRK), advanced glaucoma surgery, retinal surgery and injections into the back of the eye to our surgeon colleagues.
Part of an optometrist’s education is learning and performing in-office procedures such as removing a foreign body from the surface of the eye, inserting plugs in the tear drainage system and removing eyelashes that have grown in the wrong way. These are surgical procedures as defined by Current Procedural Terminology (CPT) definitions that are safely performed daily by Colorado optometrists. Also part of an optometrist’s education is performing removal of superficial eyelid lesions and using non-thermal (no burn) lasers to treat glaucoma and to clear up clouded tissue after cataract surgery. These would have similar “surgical” CPT codes but are a far cry from surgery as one would typically think of it. To describe these procedures as “complex surgeries” is only accurate if you consider a wart removal in your PCP’s office, a shave biopsy at your dermatologist, or an aesthetic laser treatment a complex surgery. For those of us who practice in Colorado, our education and training exceed what our statute currently allows us to do.
An independent report published by the Colorado Department of Regulatory Agencies in October 2021 clearly stated that the current Practice Act for optometrists is, “too restrictive and does not promote the optimum use of personnel,” by not allowing optometrists “to practice up to the level of their education and training.” This government agency certainly would not make a statement like this if they felt doing so would harm Coloradans. There are nine other states that allow optometrists to practice to the full level of their education and 22 states that allow more procedures than Colorado. Not a single state has shown an increase in adverse events, malpractice claims, or has had to repeal or retract any version of scope expansion for optometrists.
Colorado is home and serving my community and patients is of utmost importance to me. I could not simply stay quiet while mis-information was being propagated.
— Teresa Carlson, via letters@sentinelcolorado.com