A West Virginia circuit court invalidated a state optometry board rule that would have permitted optometrists to perform certain surgical procedures on eyelids, delivering a significant victory for physician-led care and patient safety. The legal challenge, spearheaded by the West Virginia State Medical Association and the West Virginia Academy of Eye Physicians & Surgeons Inc., successfully argued that the regulatory body overstepped its boundary when bypassing mandatory review protocols.
As our supporters have stressed, invasive procedures involving scalpel or laser instruments require advanced clinical expertise. Public health is compromised when nonphysicians attempt to undertake surgical responsibilities without undergoing the extensive education demanded of medical professionals.
Similarly, in New Hampshire, where the legislature expanded the scope of optometrists to perform eye surgery in House Bill 349, Governor Kelly Ayotte vetoed the bill. This critical executive decision strongly reinforces the importance of physician-led care for patient safety, drawing a clear line between routine vision services and advanced surgical interventions.
In her veto statement, Gov. Ayotte emphasized that laser eye surgeries are not minor procedures and that unexpected complications demand a comprehensive spectrum of clinical skills. She backed up her veto by noting that even when most operations proceed smoothly, “complications can require the full spectrum of surgical skills and training that only ophthalmologists as physicians possess.”
Nationally, physicians and patient advocates are pushing back on nonphysician scope creep. Ophthalmologist physicians undergo four years of medical school followed by up to six years of postgraduate residency and fellowship training, uniquely equipping them to handle structural emergencies that threaten permanent vision loss. Optometrists, who provide routine care, focus primarily on vision corrections, lens prescriptions, and basic screenings.
You can learn more about these New Hampshire and West Virginia developments on the AMA’s website.
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