Three months ago, Arkansas optometrists were boasting a scope-of-practice expansion win in the legislature. Now, that hard-fought authorization may be snatched from the jaws of victory as one medical group aims to return the measure to the ballot in the form of a voter referendum.

The bill, Act 579, amended optometry to include local injections, incision and curettage of chalazia, removal of superficial periocular skin lesions and some laser procedures (with training and certification). These procedures have all been approved in neighboring Oklahoma for 20 years and are now available to optometric patients over the border in Louisiana as well. The bill passed the Arkansas State Senate with a 25-8 margin in March after a similar, but even broader, proposal was rejected in February.

The legislation doesn’t sit well with some in the medical community. “We’re disappointed to learn special interests have formed a group to try to unwind Act 579,” says Vicki Farmer, executive director of the Arkansas Optometric Association. “Arkansas legislators overwhelmingly approved this measure after listening to hours of testimony and debate.”

The group challenging it, the Safe Surgery Coalition, is taking aim at a number of recently passed optometric bills across the country in states such as Alabama, Nebraska and even Pennsylvania, where Senate Bill 391 explicitly clarifies that “Doctors of Optometry may not perform surgery and that any insurance procedure and billing code may not be used to define surgery.”1 Nonetheless, the Safe Surgery Coalition’s website claims the “bill would jeopardize patient safety by allowing optometrists (who are not medical doctors or trained surgeons) to perform eye surgery.”2 The group is reportedly made up of a coalition of doctors and includes the state ophthalmological society as well as other members of the Arkansas medical community.3

If the Arkansas referendum is put on the ballot, it would essentially undo the bill and ignite a public battle—likely in the form of an advertising blitz—for the state’s ODs. To get the referendum on the ballot, the group will need to collect 53,491 signatures by July 23.4 The referendum was filed by Alex Gray on behalf of Safe Surgery Arkansas on June 11, 2019.4

“The General Assembly determined Arkansas patients deserve better. We think voters will agree,” said Ms. Farmer. “We encourage people to learn the facts before signing the petition, which will likely be circulated by paid canvassers.” 

1. Gordner J. Senate Co-Sponsorship Memoranda. Pennsylvania State Senate. January 9, 2019. Accessed June 17, 2019.

2. Safe Surgery Coalition. Accessed June 17, 2019.

3. Brown W. Ophthalmologist-led coalition looks to Arkansas ballot to unwind new law on optometry eye surgery. Talk Business & Politics. June 11, 2019. Accessed June 17, 2019.

4. Arkansas Practice of Optometry Referendum (2020). BallotPedia. Accessed June 17, 2019.