- When to consider referring for low-vision rehabilitation
- The role of sex hormones and aging in dry eye disease
- 3 reasons to read AOA’s newest clinical practice guideline
- Identifying reading difficulties in children
- Mobilizing against myopia
- New AOA clinical guideline puts focus on elevating care of glaucoma patients
- Tips for reinforcing optometry’s role in the broader health care system
- Vision loss makes list of 14 risk factors for dementia
- The ‘gatekeepers of primary eye care’
- Myopia report calls for disease classification, new federal policies
- High-tech solutions for low vision
- Optometrists play an integral role in assessing and treating patients with traumatic brain injuries.
- Primary care of the stroke patient
- Research on eye aberrations not abstract to award-winning scientists
- AOA, CooperVision mobilize to ‘disrupt the status quo,’ advance new standard of care for children with myopia
- What do the experts say on genetic testing for IRDs?
- Pediatric keratoconus prevalence higher than believed, may change care approach
- Making blurry vision clear
- Unblurring the lines
- Appreciating optometry’s value to patients with diabetes and their primary care physicians
- 9 benefits of introducing laser procedures into your practice
- Optometrist-performed YAG capsulotomies shown effective, safe and beneficial for patients
- Proof not positive yet on low-dose atropine for myopia in children
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- Legal blindness in America
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- New AOA adult eye guideline
- New technology for the advanced AMD patient
- Interprofessional communication for diabetic eye care
- Contact lens experts weigh in on gaps in consumer knowledge
- Align your team on binocular vision disorders
- How to better manage dry eye disease
- eyes the brain and learning
- Can vision intervention slow onset of dementia
- New independent task force recommendation on glaucoma screening underwhelms
- Gene therapy vision rehabilitation for IRDs
- 2022 contact lens controversies
- The latest research from AOA members
- Caring for patients with special needs
- New discoveries aid understanding of the visual system
- Don’t let the pressure get to you or your patients
- How technology has changed recommendations for visually impaired children
- 12 ways to provide better care for patients with prediabetes and diabetes
- Alzheimers and eyes
- Level up your diabetes care with specialists, services collaboration
- Behind the lens
- Contact lens developments regarding keratoconus
- Managing the care of patients with contact lens-related dry eye
- Lens-based strategies to address reading issues due to mild, disease-related vision loss
- Study shines light on optogenetics in retinitis pigmentosa
- surgical procedures courses
- Genetic Testing and Gene Therapy
- low vision in your practice
- Low percentage of patients with diabetes adhere to key self-care practices
- EBO to produce new glaucoma clinical practice guideline
- details of visual functions immediately following marijuana use
- Understanding Photophobia in mTBI
- New myopia management guidance released
- The challenges of maintaining a healthy tear film
- Integrating models of diabetic eye care
- Dry Eye and Productivity
- Contact lens innovation delivers opportunity
- How face masks affect the eyes
- Marijuana dispensaries still blow smoke over glaucoma effects
- Conjunctival Lymphangiectasia and Fabry
- Techniques to enhance contrast
- Americans remain at high risk for vision loss
- Stimulating eye and vision research
- Allergic conjunctivitis in a COVID-19 world
- Atropine in myopia control
- sleep patients ocular health
- CDC US coronavirus spread expected
- Demystifying dizziness
- Optometry and Glaucoma patients
- 5 reasons why doctors should use AOA diabetes guideline
- Growing epidemic of adolescents and young adults with prediabetes
- Improving scanning efficiency of individuals with homonymous hemianopia
- second edition of diabetes clinical practice guideline
- Pupil patterns in youth a phenomenon
- Study high school sports concussions underscores optometry role in care
- Prototype imager of tear film sublayers opens eyes on dry eye
- Retinal measurements hold clues to Alzheimers disease
- reversing prediabetes to normoglycemia can lessen microvascular complication risk
- Detecting the signs of autism at earlier age using visual cues
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- Addressing elderly vision impairment
- The AMD aspirin balancing act
- Study looks at what patients understand about their glaucoma diagnoses
- Vision Rehabilitation Clinical Pearls Lens Rx Prescribing for the Patient with Traumatic Brain Injury
- Real partners in diabetes care
- Amblyopia More than meets the eye
- New mild TBI guideline for children provides opportunity for doctors of optometry
- Reading corneal signs
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- Study looks at potential of suppressing ocular cancer in children
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- Glaucoma & Exercise
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- Study opens eyes to Alzheimers disease risk
- Understanding MGD
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- Ebola vector-borne diseases rear ugly heads again
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- Genetic Testing for AMD
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- New blood pressure guideline
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- Glaucoma protein biomarker
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- New therapeutic target could reduce diabetic retinopathy
- diabetes on the rise among the young
- Trabeculoplasty Commentary
- Seniors near vision loss dementia risk linked
- Can frequent anti VEGF injections increase glaucoma surgery risk
- Study stresses stress test in treating patients with AMD
- Contact lens helps predict speed of glaucoma progression
- Unique retinal cell dysfunction triggers myopia
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- How tilted optic discs may affect myopic eyes
- New eye test is early detector of diabetes
- Anti VEGF injections may not work for allglaucoma sooner
- New technique could diagnose glaucoma sooner
- Myopia incidence piques control efforts initiatives
- Study links visual impairment to physical and cognitive function declines
- Benefits unfamiliarity proves barrier to diabetes care
- Eyes on Alzheimers
- Association found between TBI and neurodegenerative conditions
- Spotting the link between vision problems and ADHD
- Treating the digital eye
- Statins show continued potential as treatment for dry AMD
- How doctors of optometry can diagnose a rare disorder
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- Researchers zero in on potential dry AMD treatment
- Ranibizumab proves effective to treat proliferative diabetic retinopathy
- Study shows some drivers with glaucoma naturally adapt
- Doctors of optometry a crucial component in cataract care
- Be part of the national dialogue about diabetes
- Under pressure addressing hypertension
- Gene therapy successful in treating rare retinal disorder
- The lowdown on treating low vision patients
- New study calls attention to importance of carotenoids
- 5 things doctors of optometry should know about concussions
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- Multifocal contact lens effective at treating myopia in kids
- New tool educates and motivates patients with diabetes related eye disease
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- Out of the box thinking leads to potential glaucoma treatment
- Doctors of optometry have big role in catching giant cell arteritis before blindness
- Cataract surgery lessens death risk
- Novel glaucoma therapy One ring to help them all
- Common glaucoma drugs may affect IOP measurements
- Gene mutation uncovers potential treatment for rare form of pediatric glaucoma
- How astigmatism affects reading fluency
- FDA approves first corneal cross linking system for treatment
- Cataracts and UV exposure in driver-side windows
- Virtual model aids diabetic retinopathy progression understanding
- doctors of optometry AMD assessments comparable to ophthalmologistsoutcomes
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- Are sleep apnea and asthma linked to keratoconus
- Not a dry eye
- Eye on head injuries
- Risk for macular degeneration linked to low levels of vitamin D
- Tears now fears Zika persists in eyes
- Myopia Controlling the heretofore uncontrollable
- advancing keratoconus care
- visual dysfunction after brain injury
- Study detects early biomarkers for risk of developing diabetic retinopathy
- Prevalence of Undiagnosed AMD
- Daily use of steroid drops increases risk for ocular hypertension
- Zikababy
- New study dry eye disease
- Encyclopedia of dry eye disease released
- Clinical Pearls for Seasonal Allergies
- Doctors of optometry less likely to prescribe seldom needed antibiotics for conjunctivitis
- T cells hold promise of treatment for preemies born with eye condition
- Youth Concussions
- New imaging techniques detect earlystage Alzheimer’s disease
5 considerations if you’re thinking about adding laser procedures to your practice
October 19, 2023
Doctors of optometry are performing office-based laser procedures in 11 states, as AOA affiliates have seen historic scope expansion wins in the past four years and momentum continues to build. Doctors of optometry are pursuing legislation in other states that would allow them to serve their patients at the highest level of their education and training. Some of these optometrists, who have performed hundreds of laser procedures, share key considerations in providing this care to patients.
First things first when it comes to consideration of adding laser procedures to the list of eye care services provided by doctors of optometry in their practices.
Doctors of optometry are now performing office-based laser procedures in nearly a dozen states. Some of these optometrists, who have performed hundreds of the office-based surgical procedures, such as YAG capsulotomy (after cataract surgery) or selective laser trabeculoplasty (SLT, for glaucoma) for the past couple of years, share key considerations.
Ryan Ames, O.D., MBA, practices in Wisconsin and performs about 20 procedures a month between patients at his practice and those of a colleague’s. President of the Wisconsin Optometric Association, Dr. Ames is no optometrist-come-lately to the procedures. He has performed YAG and SLT procedures for the past two years. Prior to that, he had spent 16 years providing pre- and post-operative care to the patients of ophthalmologists.
“I schedule most of my procedures one Monday a month,” Dr. Ames says. “This morning, between 8 a.m. and 12:30 p.m., I performed seven procedures. They are among the safest, low-risk procedures that can be done in eye care.”
Not that Dr. Ames takes providing this care lightly. He has made considerable investment in training and equipment for the safety and convenience of his patients, never mind years of education and training before he augmented his practice with the service.
Here are five considerations from doctors who decided to proceed with the procedures.
1) Know your law
No two scope laws are the same, says Paul M. Barney, O.D., AOA Board of Trustees member, who played a key role in passage of Alaska’s laser authority in 2017. So read your state law, and accompanying regulations, closely.
“It’s important to understand your state’s scope and what it allows and doesn’t allow,” Dr. Barney says. That information can help inform your decisions on what kind of certification you might need or even the kind of equipment to purchase, he says.
2) To add or not to add laser procedures?
So, your state has authorized doctors of optometry to perform laser procedures; should you? Every doctor has to make that decision for themselves.
There are many considerations. Dr. Ames says, for him, it was a matter of convenience to his patients.
“This is a natural extension of what we do every day,” he says. “The patients who need these procedures are mostly elderly. And they don’t want to go to another doctor’s office for a procedure that is so quick (about 15 minutes) and safe. Years ago, my parents would come back to my office very frequently after they had had a laser procedure done with an ophthalmologist and say, ‘Why don’t you do that here?’ Or rather than go to another office, they’d forgo the procedure altogether,” Dr. Ames says.
3) Preparing your practice
Doctors say laser equipment can be bought brand new or used. In one of his patient exam rooms, Dr. Ames has easy access to his combination YAG/SLT laser—the technology is available from multiple companies. “You can buy just a YAG laser or just an SLT laser,” he says. “But most people buy a combination unit.”
Doctors can educate themselves on laser systems by searching online and attending conferences with vendors exhibiting lasers, Dr. Barney says.
Perhaps the best source to find out more about the technology?
“What better way than to talk to people who are doing the procedures and see what instrument they are using, especially those optometrists in states where they are doing the procedures. Find out what they like and don’t like about it.”
4) Find training for your state certification
See your state association for training opportunities. And once again, an extended course (led by Rich Castillo, O.D., D.O.) and also a workshop (Jeffrey Michaels, O.D.) on office-based surgical procedures will be offered at Optometry’s Meeting ® 2024 in Nashville, Tennessee, June 19-22. (Stay tuned to aoa.org/news for dates and times for continuing education to be announced.)
Further, the AOA is offering a comprehensive micro-credential program designed to equip paraoptometric staff with specialized skills and knowledge for optometric surgical assisting.
The National Board of Examiners in Optometry administers a Laser and Surgical Procedures Examination for fourth-year optometry students, optometry residents and doctors of optometry.
Go to EyeLearn, the AOA's professional development hub, to view courses related to laser procedures.
5) A final consideration
“Choose your early cases wisely,” says Nate Lighthizer, O.D., associate dean at Northeastern State University Oklahoma College of Optometry, who leads the school’s well-known and well-traveled 32-hour Advanced Procedures Course. Once state-certified, doctors of optometry should consider taking the time to get comfortable with the new procedures and gain valuable experience through repetition. With that additional experience, doctors of optometry will be prepared to take on more difficult cases.