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Idaho State News

Reckless Legislation Subverts Medical Training and Threatens the Safety of Idahoans’ Eyes

Ysabel Bilbao | Eye M.D.s of Idaho

BOISE, Idaho – In a concerning move for Idahoans’ eye safety today, Senate Bill 1052 was brought forward in the Senate Health and Welfare Committee in a dangerous attempt to expand optometrists’ scope of practice through legislation rather than through education. Optometrists are important providers of basic vision care services but are not medical doctors or trained surgeons. The Idaho Society of Ophthalmology (ISO) is against this recklessly proposed legislation due to the major concerns it raises for patient safety.

SB1052 skirts around the current law which requires anyone performing eye surgery to be a licensed medical doctor and surgeon. SB1052 would remove that requirement and expand optometry’s legal scope of practice to include laser surgery on the eye. These procedures are currently only performed by ophthalmologists, who are medical doctors and fully trained eye surgeons.

To be a licensed ophthalmologist in the state of Idaho, ophthalmologists must complete rigorous training, including four years of medical school, an additional four years of residency in ophthalmology, and more than 17,000 hours of clinical and surgical training on living patients. On the contrary, optometrists are not medical doctors nor trained surgeons. They undergo an average of only 2,500 hours of training in basic eye care that includes vision exams and glasses/contact lens fitting.  All but two optometry schools are located in states where it is illegal for optometrists to perform laser eye surgery. That accounts for roughly 95-percent of optometry school students nationwide who do not have training on living patients.

“Our major concern is the huge safety risk this bill raises for our patients. Optometrists are a vital part of your eye care team, but they are not medical doctors and do not have the same extensive training as ophthalmologists,” said Dr. Brent Betts, Ophthalmologist and President of the Idaho Society of Ophthalmology. “Any procedure that requires cutting into your eye tissue with a laser is a major surgery and it should be performed by a qualified surgeon who has the training and experience to quickly handle any possible situation that arises during or after surgery, good or bad. Ophthalmology training includes treating, managing, and operating on live patients with real conditions under direct supervision of an attending surgeon. The medical education and surgical training of an ophthalmologist is simply not attainable in optometry school. A misplaced laser by even one millimeter can lead to bleeding, infection, or permanent blindless. Can you imagine losing your eyesight because someone didn’t complete the proper education first?”

In a legislative print hearing on Monday, February 6, 2023, claims were made that expanding optometrist’s scope of work would benefit residents of rural Idaho by increasing access to surgical eye care. This claim is incorrect. The fact is 95-percent of Idahoans are as physically close to an ophthalmologist as they are to their local Walmart. Additionally, there is no waitlist for laser eye surgery in any part of the state.

Similar legislation has been repeatedly presented to lawmakers in recent years; the most recent failed attempt was in 2020. The Idaho Society of Ophthalmology and the Idaho Medical Association still believe that Idahoans deserve safe and quality eye care by trained professionals and ask lawmakers to reject this attempt to lower surgical safety standards and put Idahoans eyes at risk.

To learn more about the Idaho Society of Ophthalmology, its members, and the facts about eye surgery in Idaho, please visit