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Guest Column
When training eye surgeons, should standards be lowered? | Column
Optometrists are important members of the eye care team, but performing ocular surgery is beyond their education and training.
A St. Petersburg Back to School Care Fair offered health and eye exams, immunizations and school supplies for children. What are the limits on what optometrists should be able to do? A bill pending before the Florida Legislature would allow them to perform eye surgery.
A St. Petersburg Back to School Care Fair offered health and eye exams, immunizations and school supplies for children. What are the limits on what optometrists should be able to do? A bill pending before the Florida Legislature would allow them to perform eye surgery.
Published Mar. 29
Updated Mar. 29

If people are asked “How much training is sufficient to make an eye surgeon?” they will say that no surgeon can be over-educated or overqualified. Most agree that more education, training and clinical experience is better, because eye surgery leaves no margin for error. Most would also agree that decreasing the training required of a surgeon through legislative fiat is against the best interest of patients.

Darby D. Miller
Darby D. Miller [ Provided ]

But surprisingly, the Florida Legislature is debating SB 876/HB 631, dangerous legislation that bypasses the training and the safety measures built into law and provided by our medical education system, by allowing optometrists who are neither medical doctors nor trained surgeons to perform eye surgeries. Optometrists are important members of the eye care team, but performing ocular surgery is beyond their education and training.

Ophthalmologists are medical doctors who are trained to diagnose and treat ocular and systemic diseases, and perform eye surgeries.

Ophthalmologists understand that their surgical decisions have long-lasting impacts on their patients’ vision. For this reason, an ophthalmologist must complete four years of medical school, a one-year hospital internship, three years of a surgical residency that includes performing surgery on patients, and a one- to two-year subspecialty surgical fellowship. Before being able to independently perform surgery, an ophthalmologist has completed 10 years and at least 17,000 hours of post-graduate medical education, that concentrates on clinical and surgical training.

The importance of this education and training to the making of a surgeon cannot be overstated. During these years of training, an ophthalmologist learns to treat patients, perform complex eye surgeries and, most important, how to handle unforeseen complications that inevitably will arise. An ophthalmologist must develop the time-acquired judgment to know when to operate and when to not operate. A misdiagnosis or mishandled surgical complication can cause permanent harm to a patient. The surgeon’s job is to provide patients with the best possible care, by putting safety first and minimizing risk.

Unfortunately, the passage of SB 876/ HB 631 could put your sight into the hands of an optometrist who has never acquired the education and training needed to perform safe and effective surgery. Granting surgical privileges through legislative decree without the requisite years of training is dangerous and irresponsible, and we urge the Legislature to act in the interest of patient safety by standing firmly against these bills.

Dr. Darby Miller, immediate past-president of the Florida Society of Ophthalmology, is assistant professor of ophthalmology at the Mayo Clinic in Jacksonville.