Ophthalmologists are cautioning provincial governments against proceeding with proposals that would permit optometrists to conduct certain surgeries and laser eye treatments, tasks currently beyond their authorized scope. Dr. Nina Ahuja, incoming president of the Canadian Ophthalmological Society, emphasizes the importance of keeping surgical procedures within the domain of physicians, warning that delegating even seemingly minor procedures to optometrists poses a significant safety risk for patients.
Recent reports indicate that the Ontario and Alberta governments are collaborating with optometrists to introduce changes to their practices, aiming to enhance access to eye care services. While both professions specialize in eye health, optometrists serve as primary eye care providers, holding a four-year professional degree post undergraduate studies, whereas ophthalmologists are trained as surgeons and eye disease specialists, undergoing a minimum of nine years of medical training after completing their undergraduate education.
Drawing on her extensive experience of over two decades in ophthalmology, Dr. Ahuja stresses that surgical expertise extends beyond technical skills, encompassing a deep understanding of systemic health and the importance of patients’ medical backgrounds. She likens the distinction between optometrists and ophthalmologists to that of an air traffic controller and a pilot, underscoring the unique skill set and training required for each role.
In response to the proposed changes, a spokesperson for Ontario’s health minister indicates that optometrists could potentially perform minor in-office surgical procedures under local anesthesia, utilize laser therapy for managing conditions like cataracts and glaucoma, order diagnostic tests, and independently treat open-angle glaucoma. While the proposed modifications do not include major surgical interventions such as cataract, vitreoretinal, or strabismus surgeries, the intention is to alleviate the strain on healthcare providers and facilities handling these procedures.
The Alberta College of Optometrists had put forth a proposal in 2020 to expand the scope of practice to include minor laser treatments, injections, and superficial skin surgical procedures like skin tag and wart removals. Following the ministry’s recent endorsement of this expansion in Alberta, efforts are underway to finalize the proposed changes in collaboration with the optometrists’ college. Optometrists seeking to undertake these new responsibilities would need to pass specialized examinations and complete supervised clinical practice to ensure competency in performing the procedures safely.
Dr. Allison Scott, president of the Canadian Association of Optometrists, assures that the proposed changes do not encompass operations conducted in operating rooms, such as retinal surgeries. Citing data from jurisdictions like the United Kingdom and the United States where optometrists are authorized to perform laser procedures, Scott emphasizes the safety and efficacy of such practices.
Supporting evidence from a review of optometrists performing laser procedures in the U.S. further underscores the safety record of these practices. Dr. Scott highlights the comprehensive training optometry students undergo in these procedures, including the potential complications and their management, emphasizing the need to leverage their expertise effectively.
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