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Legislators eyeing changes in Iowa optometrists’ scope of practice

DES MOINES — There were 87 “aye” votes in the Iowa House last week for a bill that would give optometrists authority to do three more things around the eyeball — things only Iowa ophthalmologists are allowed to do today. The bill would expand “injection privileges” and would let optometrists drain eyelids and give shots to treat two other kinds of conditions.

“This isn’t anything new or unprecedented. Optometrists perform these procedures already in 16 other states and in those states, Medicare and Medicaid reimburse for these procedures. (Medical malpractice insurance) providers are covering the doctors who perform these procedures,” said Representative Jacob Bossman of Sioux City.

Representative Vicki Lensing of Iowa City was one of the nine who voted against the move.

“While optometrists are trained in some things, they’re not trained in everything an ophthalmologist is,” Lensing said. “And when you’re doing procedures around your eyes, when there are needles being used — you only have one set of eyes and I want someone working on mine who is trained in case something goes wrong.”

Bossman shot back: “Can you believe that eye drops were once considered dangerous?”

Bossman suggested the move to expand the scope of what optometrists may do will improve access to eye care services, especially for rural Iowans.

“Iowa’s losing out on the best and brightest of our optometrists who have to leave the state to receive their training and many aren’t returning because they aren’t able to practice everything that they have been taught,” he says. Optometrists first get a college degree, then spend four more years in a professional program to become a “doctor of optometry.”

Ophthalmologists get a college degree, go to medical school and, after that, they have a one year internship followed by a three-year residency. This bill faces an uncertain future in the senate, where similar bills have failed in the past. In addition, a first-year senator — Mariannette Miller-Meeks — is an ophthalmologist.


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