House Bill to Define Ophthalmic Surgery and Ensure Patient Safety Heads to the Senate

Legislation that would help protect patient safety by defining ophthalmic surgery and further defining the practice of optometry passed the House on June 22, 2011, by a vote of 133-68. The bill now goes to the Senate for its consideration.

Strongly supported by the Pennsylvania Medical Society (PAMED), House Bill 838 would define ophthalmic surgery as the use of a device or instrument to cut, drain, penetrate, thermally alter, vaporize, freeze, burn, suture, probe, manipulate, or inject the eye or ocular adnexa. This can include:
  • Lasers
  • Cautery 
  • Radiation 
  • Scalpels 
  • Probes 
  • Needles  
PAMED believes that this legislation is necessary to protect patient safety, especially because there is potential for irreparable harm in a procedure involving the eyes.  

Contact your state senators and ask them to support this bill and thank the representatives who voted yes. Read PAMED's call to action.

HB 838, the Ophthalmic Surgical Patient Protection Act, simply places a definition of ophthalmic surgery into the Optometric Practice Act, where none previously existed. It takes nothing away from the current scope of practice of optometry. If enacted, this would serve as a broader template for definitions of surgery that would benefit all specialties.
 
HB 838 was introduced by Rep. John Bear (R-Lancaster).

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Comments: 23


There is no reason for the citizens of PA to accept anything less than the most highly trained eye surgeons - licensed physicians who have completed medical school, internships, and ophthalmology residencies. In response to some of the comments posted, 1) There is no problem with access to well trained ophthalmologists in Pennsylvania. Every citizen of PA is within 25 miles of an ophthalmologist. The overwhelming majority are much, much closer. 2) Optometrists and ophthalmologists use the same billing codes with insurance carriers and Medicare and are reimbursed with the same fees schedules. There is no cost saving with optometric providers. 3) As stated previously, the current Optometric Practice Act does state that optometrists cannot perform eye surgery but what constitutes surgery is not defined. HB 838 removes that ambiguity from the law. Nothing that optometrists are currently allowed to do is changed. 4) Eye surgery is a significant life event for any patient and it carries with it potential for serious complications to the eye and general health. Shortcuts (including not graduating from medical school) to skip part of the training process to become an eye surgeon (ophthalmologist) are not acceptable. HB 838 is an important piece of patient protection legislation which should be supported by Pennsylvanians.

Concerned Citizen at 9/29/2011 6:03:34 PM


I would love for everyone to read the actual Bill 838 word for word to get a full appreciation of what is actually proposed in this bill instead of relying on the paraphrasing of the Medical Society. It is in your best interest to know what you are supporting or not supporting for the good of PA residents!

June at 9/28/2011 5:07:50 PM


Bill 838 is an attempt to regulate a primary care provider by a specialty group. This might be similar to endocrinologists dictating what family docs can do for diabetes or pulmonary docs dictating what family docs can do for asthma or GI docs dictating to primary docs what they can do for reflux disease. Optometrists current law prohibits them from performing surgery and no other legislation is needed.

familyMD at 9/28/2011 4:56:25 PM


Facts of Bill 838 1) Legislation is not well written and tries to define surgery by listing what surgery "is not". 2) In order to perform surgery in Pennsylvania, optometrists would need to have a law passed to allow them to do it. 838 is a waste of taxpayer dollars and everyone's time. 3) This legislation is in reaction to events occurring in 2 other states and is a "fear based" attempt by ophthalmology to control another profession (optometry). 4) This bill will limit public access to the best technology in eye care by limiting future technology to ophthalmology only. Any new eye care technology will have to be approved through additional legislation instead of by the board of optometry. Bill 838 must be defeated. Contact your senators ASAP. The teamsters union and other large unions in Pennsylvania are against this bill because it will increase the cost to provide eye care to their employers.

Dr. GG at 9/28/2011 10:21:55 AM


O.D.'s have the lowest rates in malpractice of all Doctors in PA. They have Better access and lower costs for patients. If something is not broke their is no need to try to fix it. Bill 838 must be defeated.

Rick S at 9/27/2011 10:19:17 AM


You "Guys" should be trying to improve health care. You "Guys", don't know what you're talking about. This is very bad. You "Guys" should be ashamed of yourself.

anonymous at 7/20/2011 10:55:20 AM


Ludicrous to have one profession dictate the practice of another. Optometry's record is stellar, the profession has grown in scope and maturity significantly in the last 30 years. This is a "turf battle" that has been fought in many states, and ophthalmology loses consistently. Just look at the expansive diagnostic and therapeutic laws passed in the last 30 years. I can assure you that ophthalmology was scaring the public about optometrists blinding patients with the use of diagnostic and therapeutic medications. To the contrary, I am sure vast segments of the population who had limited or delayed access to ophthalmology, were well managed by an optometrist. On what basis does this legislation even beg to protect a patient? Optometry has done an excellent job in its transcendence the last 30 years. This legislation must be defeated.

anonymous at 7/11/2011 11:40:14 PM


Comes out to the same amount of years 3 + 2 and 4 + 1 BUT optometrists can learn it at a younger age. Neuroplasticity anyone? Younger brain = more malleable and will learn better. PS - sorry for spam. I should have consolidated.

anonymous at 7/7/2011 10:04:15 AM


Comes out to the same amount of years 3 + 2 and 4 + 1 BUT optometrists can learn it at a younger age. Neuroplasticity anyone? Younger brain = more malleable and will learn better. PS - sorry for spam. I should have consolidated.

anonymous at 7/7/2011 1:28:33 AM


and yes there are fellowships that are 2 years for ophthalmologists like retina but many optometrists can do what those retinologists do only after 4 years of study + 1 year ocular disease residency.

anonymous at 7/7/2011 1:27:22 AM


So who would you rather have take care of your eyes? Someone who completed 4 years studying just the eye and its systemic counterparts and then a 2 year ocular surgery residency (proposed optometric study) or someone who just did a 3 year eye medical/surgical residency (current ophthalmologists)?

anonymous at 7/7/2011 1:25:49 AM


This is just revenge from the ophtho community for the Kentucky legislation that allowed optometrists to do surgery. Get with the times guys. When optometry students graduate after 4 years they are fully able to take care of the whole eye in any manner except surgically (which is learned during residency). While medical student graduates are lost when it comes to caring for the eye and learn everything INCLUDING eye surgery in just 3 years. Who gets better training?

anonymous at 7/7/2011 1:22:16 AM


The intent of the bill may be good, but the language of the bill requires close scrutiny by ophthalmologists and other medical doctors before its passage. The bill defines the practice of optometry by what it is not. The law expressly limits the definition of the practice of ophthalmic surgery in its convoluted attempt to define the practice of optometry. These express exclusions may surface in subsequent legislation or in a court case in an unintended way. Also, in defining what is not ophthalmic surgery the bill lists certain devices, including branded medical devices for corneal reshaping and for retinal imaging. Without addressing whether the law as written is preempted by federal medical device law, a question to ask is whether doctors really want a state law which says that only certain kind of practitioners can use certain medical devices. The next state law may say, for example, that internists can only use medical devices that are listed as not being within the scope of cardiology, or that an otolaryngologist cannot use an instrument that is within the scope of dentistry. In addition, the inclusion of specific branded devices in the proposed legislation raises the question of how the law applies to devices made by other companies that offer alternatives or even improvements on these branded devices. Should specific brand names of medical devices be included in the law? Consider supporting a rewritten bill that defines the practice of optometry without the ophthalmic surgery definition and stated exclusions, and without the reference to a list of medical devices, particularly branded ones, in defining the scope of permitted or prohibited activities.

Student of medical regulatory laws at 7/4/2011 12:01:53 AM


Opposing opinions are welcome, but profanity will not be tolerated. Thank you.

PA Medical Society at 6/28/2011 4:08:02 PM


Do you seriously think that this kind of legislation serves to protect the public from an optometrist doing harm or might if actually prevent someone from seeking care because driving to an ophthalmologist is just too far at 5 pm? How many patients have had their eye health jeopardized by an optometrist performing a procedure vs. having to wait an additional day or days to get in an ophthalmologist's office? Please cite actual cases. Who has a better track record with malpractice cases? UNECESSARY LEGISLATION to fix a NON-PROBLEM. Finally, could this start a chain reaction among other health professions ... who wants their allied health practice act re-written by another profession ... physical therapy, chiropracty, dentistry, nurse practitioners

anonymous at 6/24/2011 8:44:05 PM


I don't believe that all the good ophthalmologists out there want to deal with taking a foreign body out of someones eye, removing eyelashes that are misdirected, or inserting punctal plugs which is essentially what this bill is trying to prevent ODs from doing if passed... ABSURD! It must just be those of us that cannot make a living performing surgery all day because their skills are sub par.

anonymous at 6/24/2011 9:34:10 AM


Are optometrists currently doing surgery? Are there malpractice claims against optometrists for doing surgery?

anonymous at 6/23/2011 8:19:35 PM


The purpose of this law has nothing to do with protecting patients. Oklahoma has allowed OD's to perform surgeries for more than 10 years and there is no evidence that a surgery performed by an OD has a greater chance of complications or poor outcome than a surgery performed by an MD. The clinical evidence needs to be examined, rather than blindly believing old school rhetoric.

anonymous at 6/23/2011 12:54:28 PM


you disguise me

anonymous at 6/23/2011 6:27:01 AM


Thanks for the feedback.

edoc at 6/22/2011 4:45:46 PM


While surgery is currently prohibited in the Optometric Practice Act, what "surgery" entails is not defined. The purpose of the bill is to remove this ambiguity from the law. This is a patient protection issue. Nothing is taken away from the current scope of practice of Optometry in Pennsylvania.

Kenneth Cheng, MD at 6/16/2011 4:57:15 PM


“Surgery” is not defined in the law. The purpose of the bill is to provide clarity by defining the term.

PA Medical Society at 6/16/2011 11:33:00 AM


What is purpose of the bill when we already have the Optometric Practice Act that states that optometrists cannot perform surgery?

edoc at 6/16/2011 11:10:51 AM

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