According to May 2020 numbers from the U.S. Bureau of Labor Statistics, there are 36,690 working optometrists across the country. BLS does not keep ophthalmologist employment data separate from other physicians.
Groups representing the two specialties have been butting heads in state legislatures for years over the scope of optometrists' practice. Here are nine things to know about background and recent developments in the "eyet wars":
1. According to the National Conference of State Legislatures, five states allow optometrists to perform foreign body removal. Four states allow advanced surgical authority, meaning optometrists have laser privileges beyond foreign body removal. Ten states allow optometrists to perform additional surgical procedures as authorized by their respective boards of optometry.
Florida
2. In an Oct. 20 Florida House Professions and Public Health Subcommittee panel discussion, two optometrists said insufficient access to advanced eye care across the state is a major reason their profession should be allowed to do procedures traditionally reserved for ophthalmologists.
3. Ahad Mahootchi, MD, a Florida ophthalmologist, disagreed. He said the problem of access is a result of many residents having insurance plans that don't include ophthalmologic procedures.
"Making non-surgeons surgeons won't fix those issues," he said, according to Florida Politics.
4. It was the latest in a decades-long legislative fight between Florida ophthalmologists and optometrists.
Virginia
5. Two state bills under consideration in Virginia, House Bill 213 and Senate Bill 375, would allow optometrists in the state to use lasers for three in-office procedures to treat glaucoma and provide after-cataract surgery care. Those procedures are currently only approved for ophthalmologists.
6. "Eye surgery should be performed by eye surgeons, who have experience and proficiency that only comes with years of education and training supervised by other surgeons and participating in hundreds of surgeries on real live people," Michael Keverline, MD, president of the Virginia Society of Eye Physicians and Surgeons, said in a statement emailed to Becker's ASC Review. "Optometrists play a key role in eye and vision care, but it is important to understand where their scope of practice should end, and that is with surgery. Ophthalmologists are the only physicians qualified to perform eye surgery and prepared to manage surgical complications that can and do occur."
7. Eight states currently allow optometrists to perform the procedures outlined in the Virginia bills, according to Amanda Umlandt, OD, president-elect of the Virginia Optometric Association.
Arkansas
8. House Bill 1251, which opened up some procedures to optometrists, became law in March 2019. An attempt by ophthalmology organizations to put the issue up for public referendum in the November 2020 general election was defeated by the state's Supreme Court on Sept. 17, 2020. A 2019 public opinion poll conducted by Impact Management Group for the Arkansas Medical Society found that nearly 65 percent of Arkansas voters opposed the bill.
9. In recent years, similar measures have been introduced but not passed in Wyoming, Texas and Illinois.