Eye doctors see long fight in ‘eyeball wars’

A long-standing battle between the state’s ophthalmologists and optometrists, known as the “eyeball wars,” is once again ramping up in Tallahassee.

At stake, according to both sides, is the health of Florida’s 38 million eyeballs.

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It may seem an arcane issue — but not in Tallahassee, where political contributions and the right lobbyists tend to grab legislators’ attention.

Involved are two groups with varying degrees of political capital, lobbyists and public-relations firms.

The optometrists — the health-care professionals who perform eye exams and fit you for eyeglasses — are a political powerhouse that gave more than $1 million to political candidates in the 2012 election cycle.

Just last week, the Republican Party of Florida picked up the dinner tab at a swanky Tallahassee restaurant for the legislative chair of the Florida Optometric Association and six Republican lawmakers as thanks for the group’s financial support.

On the other side are the ophthalmologists — the medical doctors who perform surgery and prescribe drugs for eye problems. They gave far less — just $235,016 during the 2012 cycle — and are trying to compensate by hiring two of the top lobbyists in Tallahassee, Brian Ballard and Nick Iarossi.

Both sides are hoping to end a decades-long fight over whether optometrists can prescribe drugs for eye patients.

So far, the optometrists are winning.

On Thursday, a House panel approved a bill that would allow optometrists to prescribe oral medication, something they’re now allowed to do in 47 other states. To qualify, optometrists licensed before 1990 would have to get 50 hours of training. More-recent grads would require 20 hours.

Rep. Matt Caldwell, R-Lehigh Acres, argued that optometrists go through four years of schooling, similar to dentists, and that dentists are allowed to prescribe medication. This would simply let optometrists use the “full extent of their training,” he said.

“All we’re talking about today is expanding the option of oral medication, ” he said.

Optometrists argued that this move would also save patients time and money. Ophthalmologists typically charge higher fees, reflecting their M.D. education.

Barry J. Frauens, a Nova Southeastern University optometry-school faculty member, noted that he had a condition that was essentially shingles in his eye. His faculty colleagues made the diagnosis — but they were unable to actually treat him.

“I had to leave work, be seen by an ophthalmologist,” he said.

And that’s as it should be, ophthalmologists say. Because optometrists don’t have a medical-school education, they say, they risk harming the patient if they prescribe medicine.

David Eichenbaum, a Tampa Bay-area ophthalmologist, told lawmakers that it took him years to learn how to best prescribe medicine and medication levels. Even now, he said, he still consults with other doctors, particularly if the patient is a child. The optometrists’ proposal would let them prescribe high-powered drugs including Vicodin and Xanax, Tylenol with codeine, and anabolic steroids.

Eichenbaum said that, in light of the state’s fight against prescription-drug abuse, giving roughly 8,000 more people prescribing power seemed dangerous.

“We just won our long, hard fight to reduce distribution of these drugs, shut down pill mills,” he said.

Though the ophthalmologists aren’t considered a terribly potent political force, they’re allied with one that is: the Florida Medical Association, which gave $1.1 million in the past cycle. And the eye doctors are fighting back on another front.

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