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No. 4: Therapeutics included in West Virginia Law

July 18, 2013

Editor’s Note: To commemorate 50 years of groundbreaking news in optometry, we are publishing the Top 10 AOA News stories as selected by our readers from all five decades. Please share your commentary and personal stories on the site as well (http://connect.aoa.org). The AOA News ran the following article March 15, 1976.

The West Virginia legislature in overriding a gubernatorial veto has passed legislation allowing optometrists to use drugs for diagnostic purposes. Seven states in the country have laws which allow optometrists to use diagnostic drugs, but the West Virginia law is the first to include therapeutics.

The unprecedented action of the West Virginia legislature was culminated on March 3 when the state Senate followed the lower house’s veto to override the governor’s veto of the bill.

The legislation’s new definition of optometry reads: “The examination of the human eye, with or without the use of drugs prescribable for the human eye, which drugs may be used for diagnostic or therapeutic purposes for topical application to the anterior segment of the human eye only, and, by any method other than surgery….”

As anticipated, passage of the new legislation, which goes into effect 90 days after passage, did not come without controversy.

According to John D. Janney, O.D., President of the West Virginia Optometric Association, the new legislation was opposed by organized ophthalmology led by Albert C. Esposito, M.D., president of the American Association of Ophthalmology, who is also a member of the West Virginia legislature. Ophthalmology’s contention that optometrists are uneducated and do not have clinical experience in medical treatment, however, was countered by a host of optometrists and others who testified on the bill.

Norman E. Wallis, O.D., Ph.D., President of Pennsylvania College of Optometry and Spurgeon B. Eure, O.D., President of Southern College of Optometry along with Lowell Bellin, M.D., M.P.H., Commissioner of Health for New York City and Donza T. Worden, O.D., a member of the WV legislature, were among those who testified on the bill which was first introduced in January.

Apparently never in serious trouble of becoming law, the bill was backed by the West Virginia Optometric Assn. on the grounds that “the graduating optometrist today is fully qualified, fully trained and should be allowed to use that training to benefit the state of West Virginia,” John E. Casto, O.D., president-elect of the WVOA said.

Dr. Casto explained that there are 150 optometrists practicing in 50 counties of the state, whereas there are only 32 board certified ophthalmologists in nine counties.

“The optometrist should be able to utilize his training which includes diagnosing and treatment of many commonly experienced disease processes that respond to topical application of drugs provided that he has the educational qualification and is certified to do so,” he said.

“The purpose of this new law is to allow optometrists to better care for the vision needs of the state’s population and in no respect does optometry intend to take over the practice of ophthalmology,” Dr. Casto said.

The president of the West Virginia Medical Assn. in calling for defeat of the legislation said, “The simple truth is that optometrists cannot diagnose or completely treat eye diseases. They are making a dangerous attempt to invade the practice of medicine.” Jack Lechie, M.D., further said, “There can be no justification for compromising the high quality eye care now available to West Virginians by permitting nonphysicians to care for medical problems.”

Opponents of the bill did not bring forth testimony from prominent experts in the field as did proponents, but resorted to accusations that optometry was spending large sums of money to pass such legislation.

In a letter, dated Feb. 29 to all members of the West Virginia legislature and members of the Lions and Rotary Clubs, Ralph W. Ryan, M.D., Morgantown, WV, former president of the American Association of Ophthalmology, stated that “The American Optometric Assn. is said to have had a budget of 3.5 million dollars in 1975 chiefly to lobby for such bills. Their expressed intention is to take over medical eye care and they are trying to do it, not by training for it, but by legislative means.”

The same letter also implied that each optometrist in WV had been asked for $1500 as a special assessment to lobby for the bill’s passage. Neither direct or implied accusations are true according to officials of the optometric organizations.

The actual vote overriding Governor Arch A. Moore, Jr.’s veto of the bill was 59-39 in the House of Delegates, 27-6 in the Senate; a majority of elected members being required by WV law.

According to Dr. Janney, before opotmetrists in the state can use diagnostic and/or therapeutic drugs, they will be required to pass pharmacology courses equal to those taught medical students, and no optometrists will be certified beyond their training.

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