• Optometrists pushing Beacon Hill for more flexibility in providing services

    By: Bob Dumas

    Updated:

    BOSTON - When it comes to getting eye treatment in Massachusetts, there is a push on Beacon Hill to let optometrists provide more services.

    Proponents said this would make getting care easier for patients and save health care costs.

    Ophthalmologists argue it's a risky idea.

    Paul Richardson said he visits his optometrist for his routine eye exams and a check on his glaucoma.  

    Dr. Wayne Zahka, of Westwood Eye Care & Optical, can make a diagnosis, but because he’s in Massachusetts, he can’t treat it.

    “Once we determine that the patient needs treatment, we can’t write the prescription,” Zahka said.  “That’s all it is. Eye drops.”

    Massachusetts is the only state that prohibits optometrists from writing that prescription as well as for oral antibiotics to treat a serious eye infection.

    A patient needs to make another appointment with an ophthalmologist, a medical doctor who specializes in issues related to the eye.

    An optometrist spends four years at optometry school instead of going to medical school.

    “Optometrists traditionally don’t do surgery, but we are trained to treat eye diseases, trained to diagnose, trained to take care of eye glasses, contact lenses, general vision and all pathology,” Zahka said.

    There are now a handful of bills, including one from the Gov. Charlie Baker's office, which would allow optometrists to expand their range of services.

    Dr. Mitch Strominger, a practicing ophthalmologist who also teaches at Tufts Medical Center, generally opposes these bills.  

    “I think what we need to do is actually go back to the bill and determine exactly what the optometrists want here in the state of Massachusetts," Strominger said.

    Strominger said he is concerned the bills could open the door to letting optometrists perform laser surgery or do other complicated procedures.  

    “The question is, if you have a major problem with your eye, an optometrist picks it up, who would you rather see," Strominger said. "Would you rather see someone who has done hours and hours of training on this, who is certified?”

    Richardson said he likes the idea of some change in the system, but is wondering why Massachusetts restricts a doctor he trusts.  

    “To be the only state to not allow optometrists to do this, it just amazes me," Richardson said.

    The laws limiting optometrists date back to the 1930s.  

    In recent years, bills to change the system have passed the senate seven times, but have been unable to clear the house.

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