I am an MD student (RWJMS) and my girlfriend is an OD student (NECO), so I have a unique (I believe priviledged) perspective. I generally believe that OD's shouldn't be doing surgery (as does she), but here I will provide facts, not opinions, on the matter.
1. Optometrists don't want surgery.
Yup, it may be hard to believe, but they don't. OD's care about primary eye care, vision therapy, and general clinical care for ocular disease, but they do not concern themselves with surgery. The AOA-PAC agenda does not include getting OD's to do surgery - they are more concerned about getting plano contacts by Rx only, and getting reimbursed by medicare (which my AMA has decided to make difficult for them). Most OD's would have gone to medical school and became ophthalmologists, but they didn't, because that's not what they want.
2. The reason for the Oklahoma situation.
Not enough ophthalmologists. If you want to improve the situation as an ophthalmologist, then move there. As it is now, many patients can't get surgery because of the shortage. The response was to allow OD's to perform laser procedures for retinopathy, take some of the case load off of the ophthalmologists. This is the ONLY procedure approved for them to do in OK.
3. OD's aren't taking over ophthalmology.
When maxillofacial surgery came about, ophthalmologists thought they were screwed. When OD's got Rx powers (they couldn't even dilate pupils!), ophthalmologists thought they were screwed. Ophthalmology is still one of the most lucrative and competitive residencies out there - you have nothing to worry about. Some of my ophthalmology-bound classmates were concerned that OD's were taking over surgery. This is simply not the case. They won't get it in NJ, because we have plenty of trained ophthalmologists. And the OD's don't want it. They like being optometrists.
4. The best thing is for optometrists and ophthalmologists to work together.
OD's are well trained in their very rigorous 4 years (more rigorous than medical school). They are also trained to "refer to ophthalmology" for everything they don't do. The best optometrists form relationships with ophthalmologists to provide the best care for their patients; those ophthalmologists refer back to give their patients the best primary care. When ophthalmologists and optometrists work together, everyone wins.
Now for my opinions:
I personally have had three eye surgeries (strabismus), and would never let an OD do that kind of thing - their not trained for it. My girlfriend feels the same way. But, in general, optometrists are much better providers of primary eye care than ophthalmologists. They are better trained in it, and they do it more. During 22 years with my ophthalmologist, I never had a manual phoropter refraction - surprise surprise when my VA improved after one exam with the OD (actually OD student).
As for laser surgery, most of it can be done and learned quite easily. OD's have an extremely good knowledge base for this, so I have no problem allowing a residency (yes, OD's have residencies) for laser surgery, especially when it is tied so closely into primary care (i.e. Lasik).
As for comments made by Dr. Paul Romano, editor and publisher of Binoc Vision and Strabismus Quarterly, OD's are very intelligent, talented, capable, and competant - no less so than MD's. They go through excellent training and are very good eyecare providers. Most of them could have gone to medical school and became ophthalmologists if they wanted to. But they don't, so leave it alone.
I'm sure you will get many replies or offers now! Good job.
