In Florida, the longstanding, so-called “eyeball wars” between optometrists and ophthalmologists is waging on.

Last month, an optometry bill (HB 239) that would allow ODs to prescribe oral medications—including Schedule III drugs—scored a minor victory in its first round of the legislative process. It was approved by a 10-to-3 vote within the Health Quality Subcommittee in the state House of Representatives.

“This proposal has been around longer than I’ve been alive,” said 31-year-old Rep. Matt Caldwell (R), who had introduced the bill in the House. A similar bill (SB 278) was introduced in the Florida Senate by Senator Garret Richter (R).

“We are thrilled that House Bill 239 is moving forward and that it gained wide support in today’s House Subcommittee on Health Quality,” said Ken Lawson, OD, legislative chair of the Florida Optometric Association.

The next legislative hurdle for HB 239 had not yet been scheduled at press time.

Meanwhile, Rep. Jeanette Nuñez (R) has introduced an ophthalmology-backed bill (HB 443) that enumerates a number of limitations on optometrists.

For one, an optometrist could no longer be referred to as a “physician” or as “board certified” if the bill passes.

Nomenclature aside, the bill stipulates a number of more serious limitations regarding patient care:

  • If an optometrist diagnoses a patient with angle closure, neovascular, infantile/congenital or progressive glaucoma, the OD must immediately refer the patient to an ophthalmologist.
  • Optometrists would be forbidden from performing surgery, including lasers. In this sense, “surgery” means using an instrument—laser, scalpel, probe or needle—to cut, burn, vaporize, remove or otherwise alter by incision, injection, ultrasound, laser, radiation, infusion, cryotherapy, probing, scraping or any other means. However, certified optometrists would be allowed to remove superficial foreign bodies.
  • If a patient experiences an adverse incident from an optometrist’s care, the OD would be required to report it to the health department.

A substantial portion of the bill spells out the proper procedures for the comanagement of postoperative care between an optometrist and an ophthalmologist, and that the patient be fully informed and provide consent to comanaged postop care. 

At press time, HB 443 was in committee awaiting consideration.