A new law in New Mexico expands optometrists scope of practice to specifically include minor surgical and punctal procedures. Gov. Bill Richardson signed the bill (SB 367) on April 3, despite a heated and pervasive public relations campaign by organized ophthalmology to stop the bill.

Proponents of the legislation argued that New Mexicans in rural areas rely heavily on optometrists for eye care because ophthalmologists are not readily available.

To that end, the law allows O.D.s to perform:

Removal, destruction or drainage of superficial eyelid lesions and conjunctival cysts.

Removal of non-perforating foreign bodies from the cornea, conjunctiva and eyelid.

Corneal debridement, culture, scrape or anterior puncture. This does not include removal of pterygia, corneal biopsy or removal of corneal neoplasias.

Removal of eyelashes.

Probing, dilation, irrigation and closure of the puncta.

Many optometrists in the state have been performing these in-office minor surgical procedures for the past 20 years. But, because the law didnt explicitly give O.D.s the right to perform them, insurance companies would not reimburse O.D.s for doing them, explains Albuquerque optometrist Robert Jarrell, legislative chair of the New Mexico Optometric Association.

When the bill was introduced, it set off a public outcry from organized ophthalmology. Ads on television, radio and in newspapers disparaged optometrists ability and educational experience.

In an editorial in the Albuquerque Tribune, Mark T. Chiu, M.D., president of the New Mexico Academy of Ophthalmology, wrote: This proposed legislation creates a precedent that places New Mexico at the epicenter of a medical crisis. If the state allows untrained, medically unqualified professionals to practice surgery, the vision of a countless number of New Mexicans will be at risk.

In response, We didnt do a whole lot to address the ads ourselves, Dr. Jarrell says. We didnt feel that we needed to defend ourselves against them. These were procedures that weve been performing for years.

Dr. Jarrell attributes the bill"s successful passage to basic grassroots efforts. "Regardless of how nasty the ad campaings got, or how nitty-gritty each side of the argument got, what it really cam down to was the relationships with our lawmakers at the grassroots level, and that"s really where all the work was done."

Vol. No: 144:04Issue: 4/15/2007