Senate Signs Off On Laser Eye Surgery Bill

The Senate passed a bill that would broadly expand the practice of optometry in the state. However, there were disagreements about how much those practices could be expanded. 

Proponents of the bill said that it would reduce waitlists in the state for eye surgeries that optometrists are trained, but not currently permitted, to do. 

Opponents have voiced concern over the qualifications of optometrists to practice these surgeries safely and effectively, especially in the case of an adverse reaction, or emergency during or after surgery. 

Optometrists examine, diagnose and treat patients’ eyes.

Ophthalmologists are eye doctors who perform medical and surgical treatments for eye conditions.

Senate Bill 565 would allow optometrists, the doctors who diagnose and treat, to perform some surgeries that currently only ophthalmologists, or eye surgeons, are permitted to do – like laser eye surgery. 

Sen. Laura Chapman, R-Ohio, is the chair of the Senate Health Committee, where the bill originated. 

“Our health outcomes are the worst in the state. Our citizens pay some of the highest medical costs, those of us who represent rural areas lack access to care, constituents are suffering. I’m tired of the status quo,” Chapman said. 

A strike and insert amendment proposed by Sen. Tom Takubo, R-Kanawha, and currently the only medical doctor in the Senate, would have put a pause on the proposed legislation. 

Takubo asked the legislative auditor to investigate the proposed legislation and present the findings to the legislature. That amendment failed on Friday.

“The problem with the bill is these individuals could be trained in a 32-hour course,” Takubo said. “Including emergency management of complications in the eye itself, causing acute blindness or filling up with blood and having never performed this on a human being, leave there, go to their office with no supervision whatsoever, and perform these procedures.”

Another amendment introduced by Takubo, that would put legal requirements on the amount and level of training ophthalmologists had to go through before being able to perform certain laser surgeries was narrowly accepted. 

However, Sen. Eric Tarr, R-Putnam, said while the amendment fixes problems with laser eye surgeries the bill’s problems go way beyond that. He said the bill opens up the scope of practice for optometrists so widely that anything they receive training to do, no matter how lacking, they can do under this bill. 

“This is my biggest concern with this bill,” Tarr said. “On page two. It just said that if it’s taught in a school, not that that individual was taught. And so it expands it way beyond what just that individual could be taught.” 

Chapman said that’s a non issue. 

“These boards exist to protect the public,” Chapman said. “So they’re not going to approve procedures that their members are not taught on, are not trained on. So I don’t believe that that’s an issue.”

But Tarr said this bill takes power away from the board to not only approve what optometrists can do as part of their scope of practice, but also takes disciplinary power away from the board. 

Tarr laid out a hypothetical situation that he says could happen under the bill. 

“If I’m at a school somewhere out in California that teaches a program, they put it in there for an hour, and I have evidence that they put it in there. A vendor came in for an hour’s instruction. So now that’s in my scope of practice,” Tarr said. 

“So I’m gonna give it a whim and I injure somebody, and I come before the board of optometry and they say ‘you were practicing something that you shouldn’t be doing’. I say, ‘Wait a minute, This was taught at the University of California, wherever, it’s within our scope of practice, I absolutely can.’ It’s right there in law,” Tarr said.  

He said that under the bill an attorney has a strong standing for that hypothetical individual to not to be disciplined for hurting individuals in West Virginia.

Chapman pushed back, and said there are more opportunities ahead of the legislature to work on the bill. 

“We can mince words all day,” Chapman said. “I mean, there was not an amendment on this. The other side of the building has to actually approve this as well. And so if there’s an issue, they can fix it over there.”

The bill says “Any license granted to an applicant who graduated from an accredited school or college of optometry in 2025 or thereafter, and who passed the Laser and Surgical Procedures Examination administered by the National Board of Examiners in Optometry or other equivalent proficiency examination approved by the board shall be deemed to have met the education and training criteria listed in §30-8B-5 of this code.”

It also lays out requirements for each training course the board can accept, like education on contra-indications, techniques, risks, and benefits. 

On Thursday, the full Senate had the one and possibly only chance to change the bill. Where the strike and replace amendment failed, Takubos other amendment that created training requirements passed, and was added to the bill. 

Tarr said that amendment fixed the laser part of the bill, but there are still fundamental issues with the way the bill is currently worded. 

“The problem is the bill left in language after coming out of second reading that permitted pretty much anything to go in that scope, scope of practice. If somebody can argue that it was taught in some school that was accredited in the country,” said Tarr. 

The bill passed 22 to 11. All 11 no votes were Republicans.