NEW ORLEANS -- For a second year, eye doctors packed the legislature.
Optometrists want approval to do laser and some surgical procedures. The ophthalmologists, who are medical doctors, are concerned for patient safety.
After three hours of testimony in a legislative committee hearing, optometrists won the change to bring their bill to the House floor by just one vote.
Optometrists say there are twice as many of them in the state compared to medical eye doctors, which they say means more access to eye care.
"We're scattered all over the state, whereas the ophthalmologists are generally concentrated in the urban areas, and you saw the graph of the unmet need for eye care in the future," said Dr. James Sandefur, executive director of the Optometric Association of Louisiana, and a retired optometrist.
Optometrists say patient care improved over the years as they added the right to prescribe eye drops, oral medications, pain pills and glaucoma tests to their legal list of treatments, even though the ophthalmologist, who are medical doctors, protested.
"Optometrists in Louisiana see 70 percent of the Medicaid eye care patients in Louisiana. So they need our help," said Dr. Sandefur.
But ophthalmologists say four days of surgical training, along with four years of optometry schooling, doesn't compare to 10 years of medical school and one-on-one residency training, where knowledge of the entire body, judgment calls and managing complications are learned.
A Tulane MD showed lawmakers a patient who had a brain aneurysm that caused eye pain. Her optometrist treated it as glaucoma, or eye pressure, for an entire month. He saw it and called a brain surgeon.
"If I had not made that phone call at 6 o'clock in the evening, on that Friday evening, I guarantee you this patient would have been dead in bed within two weeks," said Tulane's Dr. Ramesh Ayyala, an ophthalmologist, who is also the director of the ophthalmology residency program.
"In Louisiana, barbers must have 1,500 hours of training to be able to cut hair. Yet you're hearing that we would allow people to have 32 hours of training to cut on eyes," testified Dr. Brad Black, a pediatric ophthalmologist in Baton Rouge and president of the Louisiana Ophthalmology Association.
Ophthalmologists dispute access, saying only a small percentage of people don't have both an O.D. and M.D. in their area. And those who don't are, on average, 15 minutes away. They also say lawsuits for problems have gone up in one of the other two states to allow optometrists to do these procedures.
This isn't the only bill that the optometrists have introduced in the state legislature so that they can do more procedures. They also got one passed through the Health and Welfare Committee on the Senate side.
Those bills can now go to the full house and senate floors. Doctors say diabetes, high blood pressure, multiple sclerosis and AIDS, as well as a type of live abscess, can all show up as eye problems.