Only a handful of states allow doctors of optometry to perform the procedures today.

Optometric surgical procedures courses now available at Optometry’s Meeting®

Could surgical procedures be in the future for more doctors of optometry?

Optometry's Meeting® is offering AOA-member doctors the opportunity to find out. They can register for two separate, 16-hour courses June 20-24 in Denver, Colorado:

“It is very rewarding to treat our patients and to know the hard work you put in with your education and training is paying off and helping them.”

Advanced surgical procedures (LA00)

June 21, 1-9 p.m., and June 22, 8 a.m. to 6 p.m. 

This workshop covers the educational and technical skills necessary for optometric surgical procedures performed in a primary eye care setting. Topics include a review of facial and ocular anatomy, surgical instruments, asepsis, ocular lesions, anesthesia, injections-including intradermal, intramuscular, sub-conjunctival and intravenous-wound management, basic suture technique and techniques for performing in-office optometric surgical procedures. The indications for, alternatives to, and risks/benefits of all techniques will be discussed, as well as management of possible complications.

Laser procedures (LL00)

June 23, 8 a.m. to 8 p.m., and June 24, 7 a.m. to 1 p.m.

This workshop covers the technical skills needed to perform anterior segment laser procedures. Topics include laser physics, laser tissue interactions, gonioscopy and the most commonly performed clinical anterior segment laser procedures including YAG laser capsulotomy, laser peripheral iridotomy, green laser trabeculoplasty, selective laser trabeculoplasty, and green laser peripheral iridoplasty. The indications, contraindications, alternative treatment options, risks/benefits and procedural techniques will be discussed in detail, as well as management of possible complications. The hands-on laboratory will utilize various lasers.

Doctors can register for either or both workshops ($650 each) here. Space is limited to 40 doctors per workshop and preregistration is required.

The courses will be taught by a team from Northeastern State University Oklahoma College of Optometry, led by Nate Lighthizer, O.D., associate professor of optometry and assistant dean for clinical care services; Richard Castillo, O.D., D.O., professor of optometry and assistant dean for surgical care; Douglas Penisten, O.D., dean of the college of optometry; and Joseph Shetler, O.D., assistant professor of optometry.

The COPE-approved courses each consist of lecture, videos and hands-on lab. Attendees who complete either or both courses will receive certifications: "Laser Therapy for the Anterior Segment" and/or "Surgical Procedures for the Optometric Physician."

"This course is a continuing education course designed to build on the outstanding education that optometrists receive during optometry school and residency," Dr. Lighthizer says. "They will provide education designed to increase the training and knowledge regarding optometric surgical procedures and laser procedures. Each optometrist needs to follow the laws of their individual state, which will dictate whether or not they can perform these procedures."

Expanding scope

Only a handful of states allow doctors of optometry to perform the procedures offered in the courses. But Dr. Lighthizer cited old prohibitions that prevented doctors of optometry from dilating patients' eyes or prescribing oral medications. Those barriers have mostly fallen away.

Further, despite resistance, Oklahoma, Louisiana and Kentucky allow for doctors of optometry to perform some laser surgical procedures.

In fact, the state where Dr. Lighthizer practices was the first in 1998 to allow doctors to use a scalpel and lasers for some procedures, while other states (such as Tennessee, New Mexico, Oregon, and Idaho) allow for certain injections and "lump and bump" removals from eyelids. That's progress, he says.

"For a long time, it was just Oklahoma," Dr. Lighthizer says.

The AOA, hand-in-hand with state affiliates, is taking on new efforts to expand scope of practice so that doctors can practice to the fullest extent of their education and training and provide the best care possible to patients.

And the next barrier to fall?

"Are we doing complex retinal detachment surgeries?" Dr. Lighthizer says. "No, that's in the hands of our wonderful ophthalmology colleagues. But there are procedures that we were trained on in optometry school or during residency. There is a learning curve when you have a new procedure, but we already have the foundation and educational knowledge to do these procedures."

Beyond that, Dr. Lighthizer says, doctors are in a unique position to provide these services   from rural to urban settings-because of their number, geographic diversity and experience. He noted many doctors of optometry already co-manage patients with ophthalmologists.

"We are deciding when to refer, educating our patients about these surgeries before they are done and managing the procedures post-operatively, so it is not like we are unfamiliar with these procedures," he adds.

Who is better equipped than doctors of optometry to perform these services, he asks, considering the challenge of access to care in an aging population.

"These courses are designed for doctors of optometry who are looking to build upon the skills they already have or want to take it to the next level of optometric scope, so they are able to provide an aspect of care they might not be able to provide right now to their patients," Dr. Lighthizer says.

Seeing the light

The possibility of practicing up to the training he received in optometry school at Pacific University in Oregon and later in his residency at Northeast State University drew Dr. Lighthizer to Oklahoma. It wasn't the only reason that he settled in the Sooner State, but it certainly was an enticement.

"It's fulfilling," says Dr. Lighthizer. "It is very rewarding to treat our patients and to know the hard work you put in with your education and training is paying off and helping them."

March 1, 2018

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