Ophthalmologists are cautioning provincial governments against proceeding with proposals to authorize optometrists to conduct certain surgeries and laser eye treatments that are currently beyond their authorized practice.
Dr. Nina Ahuja, the incoming president of the Canadian Ophthalmological Society, emphasized that surgical procedures should remain under the purview of medical doctors. She expressed serious concerns, stating that assigning even seemingly minor procedures to optometrists poses a significant risk to patient safety.
This response follows reports that the governments of Ontario and Alberta are collaborating with optometrists to introduce changes to their practice. The aim of these proposed changes is to enhance access to eye care services.
While both professions focus on eye health, optometrists are primary eye care providers with a four-year professional degree post-undergraduate studies, whereas ophthalmologists are specialized surgeons and eye disease specialists with a minimum of nine years of medical training following their undergraduate education.
Drawing on her extensive experience of over two decades as an ophthalmologist, Ahuja emphasized that surgery entails more than technical skills; it requires a comprehensive understanding of the body’s functioning and the importance of a patient’s medical background.
She likened the roles of optometrists and ophthalmologists to those of an air traffic controller and a pilot, respectively, stressing the distinct skill sets and responsibilities each profession entails.
Ontario’s health minister’s spokesperson indicated that the proposed changes could empower optometrists to perform minor in-office surgical procedures under local anesthesia, use laser therapy for managing cataracts and glaucoma, order diagnostic tests, and independently treat open-angle glaucoma.
In a study analyzing ophthalmological surgeries in Ontario from 2010 to 2020, it was found that the number of patients on waiting lists surged by 74%, with the longest queues observed for cataract, vitreoretinal, and strabismus surgeries.
Although the proposed changes do not encompass the aforementioned surgeries, the intention is to alleviate the strain on healthcare providers and facilities offering such services by allowing optometrists to undertake additional responsibilities.
In 2020, the Alberta College of Optometrists proposed broadening the scope of practice to include minor laser treatments, injections, and superficial skin surgical procedures like skin tag and wart removal. The Alberta Ministry of Primary and Preventative Health Services recently endorsed this expansion and is collaborating with the college to finalize the proposed amendments.
Optometrists seeking to perform these procedures would need to pass laser and minor surgical examinations and complete supervised clinical practice to gain authorization. The ministry noted the college’s willingness to refine its proposals to address patient safety concerns, without specifying the exact adjustments.
Dr. Allison Scott, head of the Canadian Association of Optometrists, clarified that the changes do not encompass procedures conducted in operating rooms such as retinal surgeries. She cited data from the UK and US, where optometrists are authorized to perform laser procedures, demonstrating the safety and efficacy of such practices.
Furthermore, Scott highlighted that optometry students receive comprehensive training on the proposed procedures, potential complications, and their management, emphasizing the need to leverage their expertise effectively.
Overall, optometrists are equipped with rigorous training to understand risks, safety protocols, and the ability to manage cases competently, ensuring a high standard of care and patient safety.
