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Proposed state bill would allow optometrists more freedom; ophthalmologists disagree

Optometrists leaving Texas to practice in other states, organization says

SAN ANTONIO – Eyes are sensitive to the touch and have many pain-sensing nerves.

Ophthalmologists, who went through medical school, said they should be the only ones doing surgical eye procedures.

But optometrists, who do not have to go medical school, disagree. They say there's a gap in services.

That is why they are pushing for a state bill that would change their limitations.

Ophthalmologist Dr. David Shulman said those changes could be dangerous.

"The eye is a very tender organ," Shulman said. "It's why if you scratch the eye, you have instant pain." Shulman is a practicing ophthalmologist in San Antonio. He went to medical school and has eight years of training in eye care.

Shulman is not an optometrist, which is considered an eye specialist. Optometrists are not required to go to medical school. Instead, they go to four years of optometry school.

Optometrists conduct eye exams, prescribe corrective lenses and identify eye conditions. Currently under Texas state law, if patients have glaucoma or cataracts or need eye surgery, they must see an ophthalmologist.

That could change if Texas House Bill 1798 passes. The bill would allow optometrists to prescribe narcotics and do eye injections and certain eye laser procedures, which could mean treating glaucoma.

Shulman is against this bill for many reasons. First, he does not understand the need to prescribe narcotics.

"In ophthalmology, I rarely if ever use narcotics," Shulman said.

Shulman said optometrists don't have the proper training for certain procedures. He said the slightest wrong move can lead to severe side effects, including losing your sight.

"It's not a simple procedure if there's a complication," Shulman said. "We know how to take care of complications."

Focus Texas, a group pushing for the bill, said the laws for eye care in Texas are outdated.

The group's website said Texans with vision-threatening viral infections can't get the prescription medication they need. They must see an ophthalmologist, which the group said costs patients time and money and unnecessarily prolongs the time without treating the infection.

KSAT reached out to Rep. Craig Goldman, who filed the bill. Goldman did not immediately respond to the request for comment.

Focus Texas said optometrists are leaving Texas to practice in other states where they can perform more services.

The group also said the number of ophthalmologists is decreasing, while the number of patients needing eye care increases.


About the Authors:

Sarah Acosta

Sarah Acosta joined the KSAT12 News team in April 2018 as a morning reporter for Good Morning San Antonio. She is a native South Texan girl, hailing from Corpus Christi.