If you or a loved one needed eye surgery, would you feel comfortable if the person holding the scalpel told you they never went to medical school? 

Would you feel reassured if they told you not to worry because they sat through a 32-hour lecture about how to perform the operation? For most, the answer is clear – there is no room for compromise when it comes to our eyes and vision. 

Only medical doctors with the extensive training to master eye surgery should be allowed to perform it.

That’s why we are shocked at the recent introduction of House Bill 218 by lawmakers in Helena. This bill would allow optometrists—who are not medical doctors or surgeons—to perform surgery on patients’ eyes and eyelids with scalpels and powerful lasers.

This is wrong. Montanans deserve the highest quality care, especially for procedures as complex and delicate as eye surgery.  Our leaders must reject any legislation that lowers patient safety standards.

We often hear from people who aren’t certain about the differences between ophthalmologists and optometrists. Both professions are important for ensuring eye health, but their levels of education, training, and responsibilities are vastly different.

Ophthalmologists are trained medical doctors who attend more than 10 years of progressively intensive higher education, including years of clinical and surgical training supervised by licensed surgeons. Throughout this process, they gain an average of over 17,000 hours of experience before they are allowed to operate on patients independently.

What makes optometrists different? In short, they do not attend medical school and do not undergo specialized surgical training. Instead, they go to optometry school and are well-qualified to provide basic eye health services, diagnose problems with vision, and give patients lens fittings. 

Yet, some lawmakers want to let them perform complex surgeries on patients’ eyes after completing a mere 32-hour training course.

While advocates for House Bill 218 point to a few other states that have loosened their care standards, they are ignoring the serious concerns coming out of these states, including reports of complications and harmful patient outcomes. With long-established risks of optometrists performing eye surgeries, such stories are sadly becoming more common.

Laws preventing optometrists from performing these surgeries are not outdated; they protect patients from unnecessary risks and complications.

And, while access to quality care is critical for patients in rural communities, it cannot come at the expense of their safety. Rather than lowering care standards, policymakers should focus on strengthening healthcare infrastructure in rural and underserved areas that need more ophthalmologists. 

Montana’s ophthalmologists are already providing comprehensive, quality care to patients across the state; there is no reason to put patients at risk of devastating and sometimes irreversible consequences like blindness.

Again, there is no denying that optometrists play important roles in patients’ vision care and eye health; however, they simply do not have the training needed to safely perform scalpel and laser surgeries.

Montana has a history of maintaining high healthcare standards – a standard that our lawmakers should uphold by rejecting House Bill 218. The proposed bill doesn’t prioritize patients—it expands optometrists’ scope at the expense of patient safety and public health. Montanans, and their eyes, deserve better.

Gus Stein, M.D. is the President of the Montana Academy of Ophthalmology and a practicing eye surgeon specializing in pediatric and comprehensive ophthalmology in Kalispell. Kristy Moeller, M.D. is the Vice President of the Montana Academy of Ophthalmology and a practicing eye surgeon specializing in comprehensive ophthalmology including advanced cataract surgery in Bozeman.