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April 1, 2023

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Vancouver legislator proposes bill to allow optometrists to perform surgery

By , Columbian staff writer

A proposed bill from state Sen. Annette Cleveland, D-Vancouver, that would allow optometrists to perform a wider range of services came under fire Tuesday morning during a public hearing before the Senate Health and Long Term Care committee.

“To be clear, optometrists are not equivalent to ophthalmologists and are simply not trained to diagnose and manage complex eye disease, including the indications for performing and managing the complications of the surgeries they are requesting,” Dr. Courtney Francis told the committee.

Francis, who is an associate professor at the University of Washington and president of the Washington Academy of Eye Physicians and Surgeons, said optometrists play an important role in managing eye care but Substitute Senate Bill 5839 would expand their role too far.

Currently, optometrists can prescribe eyeglasses and contact lenses, test visual acuity, prescribe visual therapy and adapt prosthetic eyes. With additional education, they can also prescribe oral or topical medications for the purpose of treatment or diagnosis. The proposed bill would allow optometrists to perform certain procedures, like removing a foreign body from the eye, placement of membranes or plugs, or using laser or ultrasound instruments for diagnosis or therapy, among others.

Cleveland, who chairs the committee, said she knew there would be strong opinions about the bill.

“I’m well aware how contentious scope of practice discussions can be. That said, we know that health care is patient centered. As policymakers, we have to keep that in mind, and all policies that we consider need to be patient centered, need to be patient focused,” Cleveland said during the hearing.

Cleveland said patient access and safety are critical, noting access can be particularly challenging for those living in areas that border other states when there are often differences in the scope of practice between the two states.

“Patients in my district often share with me their concerns about eye care needs that they have and that they’re forced to drive across the river to another state to address,” she said.

Vancouver optometrist Dr. Nicholas Jankowski was among those testifying in support of Cleveland’s bill. He said educational requirements for optometrists are outpacing the state’s laws.

“Over the last 20 years … the education levels have continued to expand and grow at optometry schools across the country. All optometry schools now provide ample education on eye disease, diagnosis, treatment and management plans including hands-on training for surgical intervention with lasers, eyelid injections and eyelid lesions removal,” he said.

Dr. Jeffrey Mattson, who practices in Tacoma and Alaska, said passage of the bill would especially benefit rural residents. Mattson said rural residents often don’t have access to an ophthalmologist and have to wait weeks or months to schedule an appointment which also requires a lengthy drive.

“Nearly 40 percent of Washington counties do not have access to an ophthalmologist, whereas all but three have access to an optometrist,” Mattson told the committee.

While the Optometric Physicians of Washington is supporting the bill, other groups like the American Medical Association and Washington State Medical Association are opposed.

The bill will next come back before the Health and Long Term Care committee for executive session review. The date for that review has not been set.

To watch the full hearing, go to