Letters to the Editor

ODs Reply to Laser Editorial: “Thank You”

■ Dr. Patterson's “Open Letter to Optometry” (Viewpoint, April 2011) succinctly points out the need for a sensible truce, or rather partnership, with ophthalmology. Though your presentation is biased, your conclusions are correct. Optometry rightly needed diagnostic legislation to improve patient care. I practiced illegally during the 1970s using Fluress for applanation tonometry, Mydriacyl to perform BIO, and cycloplegics to accurately refract young children. Without these agents, I would have missed patients with glaucoma, retinal detachments, retinal tumors, anisometropic amblyopes, and the list goes on.

During the 1980s, I had an ophthalmological partner, which allowed me to prescribe therapeutics. Without these therapeutic rights, optometry would not have been able to survive. Insurance companies would not have included us on panels and patients needing treatment would never have been able to see an ophthalmologist. I believe our use of therapeutics has led to better patient care. No one died from utilization of either diagnostics or therapeutics, as organized ophthalmology would have led legislators to believe. Your associations' persistent presentation—“if legislators pass these laws, patients would die”—just appeared to be ridiculous and economically biased.

I believe, like you, that we do need a universal national peace agreement. Optometrists in all 50 states should have full therapeutic rights (oral and topical) and the right to remove foreign bodies that are superficial to the anterior stroma. I do agree with your statement that your education has great value and a line needs to be drawn. I agree that line is surgery via a knife or laser. We do not have your training or experience. There is enough for us to do as primary care optometrists. As a matter of fact, if I keep up with my profession properly, I don't have the time to learn yours.

We need your specialty to provide the most advanced care in the world. We need to partner with you and drop the swords. We need each other to provide optimum care. Surgery is your providence, and any optometrist who believes otherwise should become an ophthalmologist. So, Larry, how do we make this happen?

—Jeffrey Cooper MS, OD

■ Many ODs truly agree with your sentiments; we know that we haven't been trained to do surgery. Those of us who are realistic also know that you cannot and should not give weekend courses for surgical procedures and expect us to handle anything that comes along.

I chose optometry instead of ophthalmology because I did not want to go that extra route to do surgery. I do not understand why some in my field want to reinvent the wheel and are vehement about it. If you want to be a surgeon, go to the appropriate place and study it. It's already there for you! Don't drag the rest of us into a situation we don't want.

I like the small malpractice payments I make. I don't think many of those ODs understand that the malpractice costs are astronomical if you start doing minor surgery. You will need a much larger patient load to cover that extra liability. How many postop YAGs do we think we will get to do when most patients will want to see their original surgeon? I guess after the ODs discover that truism, the next step is to do cataract surgery too so we can afford the insurance.

I personally will not go to an OD who does surgery. I want the doctor who already has that experience, training and knows all the pitfalls.

Your article was well written, and I am glad your publication and our Optometric Management had the foresight to publish your message.

—Gordon Thomas, OD

■ I have been an OD in private practice for 38 years and have seen all the changes you referred to. Suffice to say that I completely agree with your comments and assessments. I could expand on this much further but, because of your position, I wouldn't want my comments used against my profession in any of your further editorials. Thank you for your correct insight and evaluation.

—Stuart P. Creson, OD

■ I just read your open letter to optometry. I totally agree with everything you said. We have too many ODs who want to be junior ophthalmologists. I agree with you: we should quit while we are ahead. Those who want to do surgery should go to medical school.

—John Chatelain, OD

■ Thank you for your open letter to optometry that was republished in Optometric Management. Gone are the days of ODs curing pathology with +0.50 reading glasses and MDs warning ODs will blind patients with tropicamide-induced angle closures. There are enough patients for all of us and too many overweight lobbyists on the planet. Yours is a rare voice of sanity. Hopefully there will be more in the “three Os” in the years ahead.

Thanks again!

—Paul Roline, OD