Massachusetts Glaucoma Patients Suffer Because Of Outdated Eye Care Rules

By Dr. Matthew Forgues

Glaucoma patients across the United States can receive treatment from their optometrists. In Massachusetts, however, more than 60,000 glaucoma patients are barred by state law from seeing an optometrist, which means they must wait longer for care—often for weeks or even months. And then those patients must pay at least 50 percent more for care because ophthalmologists charge higher fees than optometrists.

Massachusetts also bars optometrists from prescribing oral medications for eye ailments, including anti-bacterial, anti-viral and glaucoma medicine or administering injections such as EpiPens to treat anaphylaxis.

Optometry legislation pending on Beacon Hill, which is backed by more than 100 legislators, offers a powerful remedy to a longstanding issue. Recent passage of the bill by the Massachusetts Senate means that a vote by the House of Representatives and a signature from Governor Baker is all that’s needed to modernize optometric care. The bill remains stuck in the House Ways & Means Committee, however, with no indication that it will be released before the end of the current legislative session on July 31st.

This is unconscionable. Between barriers to access for glaucoma care and limits on medications, patients face increased risk of health complications. Diagnosis and managed treatment of glaucoma offers the best protection against the risk of vision loss or blindness. Yet Massachusetts continues to deny patients the right to seek treatment from trained and licensed eyecare professionals.

The story of a patient at the Brockton Neighborhood Health Center’s eye clinic highlights the need for modernized eye care laws in Massachusetts. An optometrist who practiced in Brockton recently shared the story of a patient in desperate need of glaucoma drops with no means to travel into Boston. Lacking access to medicine and treatment, this man was subsequently diagnosed as legally blind and placed on full disability at great cost to the state and federal governments.

One simple reason to pass the legislation is found in the numbers. There are an estimated 350 to 400 ophthalmologists who practice in Massachusetts, with a majority situated near or in established medical centers By comparison, approximately 1,000 optometrists practice in Massachusetts, with substantially greater geographic distribution outside greater Boston. Optometry locations outnumber ophthalmology offices in western Massachusetts by a 10 to 1 ratio, and there are five times as many optometry locations than ophthalmology offices north and south of Boston. Given these numbers, it is clear that increased access to optometrists would benefit patients.

The standard of optometric care in Massachusetts has raised eyebrows outside the Commonwealth. In February, the Department of Justice’s Antitrust Division and the Federal Trade Commission (FTC) publicly urged the Massachusetts legislature to expand the services that optometrists can provide to glaucoma patients.  The DOJ and FTC letter reminded the legislature that enhanced competition among glaucoma care providers, including greater access to timely and cost competitive care, benefits patients.

At the bottom line, glaucoma patients deserve easy access to direct care. The time has come for Massachusetts to catch up with the rest of the United States by passing the “Glaucoma Bill.”

Dr. Matthew Forgues is president of the Massachusetts Society of Optometrists

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