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Texas Eye Doctors Fight "Crazy" System

SAN ANTONIO – Walmart and other big box stores backing State Question 793 argue that allowing their stores to open optometry clinics in retail spaces would make Oklahoma more like its neighboring states. But eye doctors in Texas are trying to change what one optometrist calls a “crazy system” that leaves patients with urgent eye-care needs waiting for weeks for vital treatment, sometimes in significant pain or discomfort.

Texas optometrist Dr. Tommy Lucas, writing in the San Antonio Express News, says that “Texas law unreasonably limits the services we can provide our patients despite our extensive professional training.” As a result, he says, patients are subject to greater inconvenience and expense and sometimes face delays that can jeopardize their health.

One example is the treatment of glaucoma. In Oklahoma, any optometric physician can diagnose and treat glaucoma. In Texas, however, optometrists must refer a patient to an ophthalmologist.

“The patient often becomes upset when told that it usually takes more than a month to get an appointment with this second provider,” writes Dr. Lucas. In the meantime, their vision may continue to permanently deteriorate. “It’s important to note that no other eye disease is handled with such a crazy system,” he writes.

Dr. Lucas provides a second example: “A patient recently came to me with an obvious case of herpes zoster ophthalmicus. This patient was in severe pain from the condition, and immediate treatment with oral anti-viral medication was necessary. Unfathomably, doctors of optometry in Texas are not allowed to prescribe oral anti-viral medications — a much-needed class of drugs in eye care. Texas law forced me to call this patient’s primary care provider to prescribe the correct medication. Maddeningly, I could not get the provider on the phone until the following morning. My patient needlessly suffered severe pain overnight due to this erroneous barrier to his care,” Dr. Lucas writes.

In Oklahoma, the patient would have received immediate treatment from an optometrist.

Joel Robison, executive director of the Oklahoma Association of Optometric Physicians (OAOP), said that Dr. Lucas’ complaints echo what many Oklahoma eye doctors fear will happen in the Sooner State should SQ 793 pass.

“Our laws, combined with the regulations developed by the Board of Examiners, give optometric physicians a very broad scope of practice in Oklahoma,” said Robison. “But State Question 793 allows Walmart to reign in that scope and limit a doctors’ practice.”

Robison said Walmart will likely reduce procedures and treatments that are unrelated to the sale of glasses.

“Treating glaucoma is not a profit driver,” said Robison. “Neither is administering anti-viral medication. Selling glasses is where Walmart can make money. What we are going to see in Oklahoma if SQ 793 passes is exactly what we’ve seen in Texas: a reduced scope that deemphasizes medicine and overemphasizes sales. The people who suffer most under that arrangement are patients in need of real medical care.”

Dr. Amber Roby of Oklahoma talks about the dangers of corporate pressure and a reduced scope of care

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