CMA Files Suit Over Optometrists' Scope of Practice

Another major scope-of-practice fight went to court in California Tuesday when two large physician groups filed suit to prevent optometrists from treating glaucoma.

The California Medical Association and the California Academy of Eye Physicians and Surgeons say they object to new rules that took effect Jan. 8 that allow optometrists to complete their certification process "without having to treat a single patient with glaucoma."

Previous to the new rule, optometrists were required to treat 50 glaucoma patients over a two-year period, and do so under the supervision of a board-certified ophthalmologist.

"These new regulations are not up to snuff and in fact jeopardize the quality of eye care Californians deserve," said CMA president James Hinsdale, MD. "Failing to require certification that includes treating actual glaucoma patients is the equivalent of handing out driver's licenses to people who have read a driving manual and attended a class but have never driven a car."

The plaintiffs point to a widely publicized case involving the U.S. Department of Veterans Affairs in Palo Alto and allegations that several patients experienced significant vision loss while under the care of optometrists. The VA was said to have informed two of the patients who became blind that improper care was responsible. Another 87 patients at risk of harm were reassigned to ophthalmologists.

"At least seven veterans suffering from glaucoma were reported to have gone blind (and over 100 other veterans suffered either 'progressive visual loss" or ere identified as being at high risk for losing their sight) as the potential result of having received substandard healthcare from the Optometry Department of a Veterans' Affairs facility located in Palo Alto," the physicians said.