Optometrists Cannot Perform Laser Eye Surgery, Judge Rules

The state Board of Optometry’s rule allowing the professionals it regulates to perform the laser eye procedure known as photorefractive keratectomy, or PRK, has been voided by a district judge.

“The PRK procedure … is a surgical procedure,” 4th District Judge Duff McKee wrote in his 14-page order. “Optometrists are not currently authorized to perform surgical procedures of any kind.”

McKee said the state Legislature must expand the definition of “optometry” either to generally permit surgery or to specifically allow the PRK procedure before the board’s rule would be appropriate.

Board officials did not respond to requests for comment.

But the medical community said McKee had made it clear that PRK is surgery and not in the purview of optometrists.

“Optometrists are an important part of the eye-care team,” said H. Dunbar Hoskins, executive vice president of the American Academy of Ophthalmology. “We respect their ability to correct patients’ vision by prescribing glasses and contacts. Laser surgery, however, is not part of their scope of practice.”

The Idaho Medical Association, the Idaho Society of Ophthalmology and the American Academy of Ophthalmology went to court last May to block optometrists from performing PRK after more than 30 of the procedures had been performed in Idaho.

PRK, which costs about $2,000 per eye, involves flattening the cornea with a laser to correct nearsightedness and astigmatism of healthy eyes.

The Board of Optometry maintained that the Legislature had created it in 1974 to supervise the profession and that defining the practices of optometry and medicine is a function of the Legislature, not the courts.

The board also maintained that authority for optometrists to use lasers to improve human vision was established by a state law that allows optometrists “to employ any means for the improvement of human vision.”

While McKee rejected that interpretation of the law, he declined to determine whether an optometrist performing PRK constitutes practicing medicine without a license because no individual optometrists were named in the lawsuit.