Optometrists seek to prescribe drugs, operate

AUGUSTA — Maine optometrists and eye doctors are squaring off over a proposal that would allow optometrists to perform laser surgery and prescribe drugs.

The bill would grant optometrists the ability to write prescriptions and treat eye conditions that physicians are allowed to treat, including glaucoma, a degenerative condition of the optic nerve.

Peter Hedstrom, president of the Maine Society of Eye Physicians and Surgeons, said the proposed bill presents a public health risk.

“If this thing passes, you’ll have surgeons who never went to medical school,” Hedstrom said.

Hedstrom said many other conditions, including certain tumors and aneurisms, mimic the symptoms of glaucoma. Only physicians, he said, are appropriately trained to manage the care of the disease.

He also said it’s impossible to separate eye disease from other diseases, and pointed out that medicines meant to cure eye problems can have side-effects throughout the body.

“If you want to practice medicine,” Hedstrom said, “you ought to go to medical school.”

But Scott Ferguson, a Fryeberg optometrist and president-elect of the Maine Optometric Association, disagreed.

He said Maine’s 177 optometrists believe “you don’t have to learn how to deliver babies and treat fractures in order to learn how to treat eye disease.”

He said the bill would widen access to eye care and reduce costs. Rep. Robert A. Cameron, R-Rumford, who introduced the bill, said the measure would help Maine’s elderly — particularly those in rural areas.

“Many of the elderly lack mobility for long-distance travel, so it’s a real hardship on those folks to get access in some cases to the ophthalmologists.” In some cases, he said, glaucoma goes untreated because patients can’t reach doctors.

“But allowing an optometrist to use a laser is similar to allowing a mechanic to fly an airplane,” said Robert Neger, a San Francisco ophthalmologist and spokesman for the American Academy of Ophthalmology. “Clearly, the fact that you can fix an airplane doesn’t mean you can command one.”

Optometrists in 41 states may treat some eye diseases, Cameron said, and optometrists in 29 states are allowed to treat glaucoma. Optometrists in 19 states may prescribe drugs.

Cameron said the real issue is turf. “Medicine sees this as an encroachment by limited-license professionals into areas they’ve traditionally controlled.”

The bill is before the Legislature’s Committee on Business and Economic Development.