Broaden access
Optometrists can provide care
Imagine you live in a rural Arkansas community with limited access to health care. While there aren’t any medical specialists based in your county ( or even the surrounding counties), your town does have a fulltime doctor of optometry. You’ve seen this optometrist for years, trusting him to meet your eye- care needs.
You have a small growth on your eyelid that’s bothering you, so you ask your optometrist to remove it. The same doctor performed a surgical procedure in his office last year, removing the shard of metal that flew into your eye while mowing. Compared to that, removing a small skin tag on your eyelid should be simple.
However, your optometrist tells you that while it is in fact a minor, non- invasive procedure, and one he’s trained to perform, he’s not allowed to— it’s against Arkansas law. He says you’ll have to drive over two hours, round trip, to see a specialist. ( Your optometrist is also trained to recognize cancerous growths and assures you that this growth isn’t suspicious at all. If it was, he would immediately refer you to a specialist.) You don’t have the time or resources to take off work and drive out- of- town for this minor procedure, so you decide to just live with it.
Under current state law, similar scenarios are playing out in rural communities across Arkansas. The law governing the practice of optometry in Arkansas hasn’t been updated in over two decades. As with any field, optometric procedures and technology have advanced considerably over the last 20 years. However, the law excludes optometrists from being able to provide many minor, non- invasive procedures we are trained to safely provide and that our patients expect to receive. As the president of the Arkansas Optometric Association, I can tell you this is not only frustrating for the more than 400 doctors of optometry practicing in our state, but also for our patients.
Optometrists practice full- time in over 80 percent of counties in Arkansas, while ophthalmologists ( specialists who perform major eye surgery) are based in only 30 percent of counties. Forcing patients to visit a specialist for minor procedures we could safely perform in- office delays patient care, often requires travel ( especially difficult for elderly patients) and costs more money.
House Bill 1251, currently under consideration by the Arkansas Legislature, would address this by allowing Arkansas optometrists to offer our patients care we are trained to safely provide, and that optometrists in many neighboring states already provide. Optometrists in 18 states, including Oklahoma, Louisiana, and Tennessee, have a higher scope of practice than those in Arkansas. As an optometrist licensed to practice in both Arkansas and in Oklahoma, which expanded scope of practice over 20 years ago, there are several procedures I can perform in Oklahoma that I’m not allowed to provide my patients in Arkansas.
This impacts our ability to keep our best and brightest in the state. Last year, 20 percent of Arkansans graduating from optometry school chose to live in a state where they can practice to their full scope of training instead of returning home to Arkansas. O ptometrists receive four years of post- graduate, highly intensive training on the diagnosis and treatment of eye disease in optometry school and are trained to perform these procedures.
This bill includes minor, in- office eyelid procedures, as well as laser procedures for glaucoma and post- cataract surgery indications. We are not talking about allowing optometrists to perform major surgeries, or provide any care we aren’t thoroughly trained to provide. We would simply be allowed to perform additional minor, non- invasive procedures to treat conditions we already manage, within standards overseen by the state Board of Optometry, just as they are now.
The bottom line is Arkansans deserve affordable access to the highest standard of care— care that trained Arkansas optometrists can and should be allowed to provide for their patients.