Protecting Florida’s eye patients


Managing your health in today’s ever-changing health care landscape can be a challenge. Not only are you faced with trying to understand federal laws but you also need to navigate state laws that can have a dramatic impact on your care.

During the 2013 legislative session in Florida, the Florida Society of Ophthalmology (FSO) advocated for an important healthcare bill that ensures quality eye care and safety for all Floridians. It contains several changes that Floridians should be aware of when seeking eye care.

The bill was forged in agreements between Florida’s optometrists and Florida’s ophthalmologists, two important providers of eye care. To better understand the changes in the law and how they may affect you, it is necessary to understand the differences between these two distinct eye care professionals.

An ophthalmologist — eye MD — is a licensed medical or osteopathic doctor (MD or DO) who specializes in eye and vision care. Ophthalmologists are specially trained to provide the full spectrum of eye care, from prescribing glasses to complex and delicate eye surgery.

An optometrist does not go to medical school, like an ophthalmologist, but instead completes a four-year course in optometry. An optometrist measures a patient’s range of vision and also prescribes the power of the glasses or contact lenses, if vision correction is needed.

The new law that passed in 2013 clarifies several items that have been deliberated and discussed for many years between optometrists and ophthalmologists. The Florida Society of Ophthalmology advocated for many of these changes, all in the best interest of patient safety. The bill (CS/CS/HB 239), now Florida law, contains important safeguards for Florida’s eye patients including the following:

• Reaffirms that optometrists are prohibited from performing “surgery” of any kind

• Provides a clear definition of “surgery” modeled after the definition set forth in the American College of Surgeons Guidelines.

• Limits prescribing authority for optometrists to only 14 oral medications (with restrictions). The law states that optometrists cannot prescribe specified drugs for more than 72 hours. Furthermore, the new law prohibits optometrists from prescribing any analgesics (painkillers) or controlled substances except Tramadol and Tylenol 3, and those may only be prescribed for relief of pain due to ocular conditions of the eye, and may not be prescribed for more than 72 hours without consultation with an ophthalmologist.

• Mandates that optometrists timely report to the Department of Health when a patient experiences adverse incidents that can be reasonably attributed to the prescription of oral medications.

• Prohibits optometrists from giving injections or utilizing any other invasive techniques.

• Requires transparency in “co-management” arrangements that govern the relationship between the ophthalmologist who performed the surgery and the optometrist who may be providing some of the follow-up care. The patient must be fully informed of, and consent in writing to, the co-management relationship for his or her care, as well as the fees, if any, to be charged by the optometrist and the ophthalmologist performing the surgery.

Our eyes are an important, but often overlooked, part of overall health. When having a thorough eye exam, eye care professionals can often detect and predict whether you are at risk for diabetes, multiple sclerosis, hypertension, stroke and heart disease.

If you are due to see an eye care professional soon, make sure you understand these changes in Florida law so that you are fully informed of who is caring for your eyes and what limits, if any, they have on handling your care.

Dr. Jaime H. Membreno is president of the Florida Society of Ophthalmology.

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