Alberta’s new rules allowing optometrists to perform certain laser procedures, minor surgeries, and injections took effect Nov. 1—and three national and provincial medical organizations warn the changes could threaten patients’ sight.
The Canadian Ophthalmological Society, the Eye Physicians and Surgeons Association of Alberta, and the Alberta Medical Association’s Section of Ophthalmology all want the United Conservative Party government to reverse its decision, saying the expanded procedures carry serious patient safety risks that require medical and surgical training beyond what optometrists receive.
The Prairie province is the first in Canada to allow qualified optometrists to perform certain minor surgical procedures.
A fundamental difference in training
Dr. Colin Mann, chair of advocacy for the Canadian Ophthalmological Society (COS) and past president, says optometrists are valued partners who play an important role in primary eye care, but their education and clinical training are fundamentally different from that of an ophthalmologist.
Ophthalmologists complete four years of medical school followed by five years of supervised residency. By comparison, Mann pointed to the University of Waterloo’s procedures course for optometrists, which allocates roughly 40 hours to the procedures in question.
“That’s approximately the equivalent of one week,” said Mann. “Learning how to perform a procedure is not the same as knowing when—and perhaps more importantly, when not to perform it.”
The Alberta government says the expansion will improve access to care, particularly in rural communities
Under the new rules, optometrists must pass examinations and complete supervised procedures on live patients before receiving individual authorization. The Alberta College of Optometrists will oversee implementation.
At a Government of Alberta press conference on Oct. 26, Justin Wright, minister of primary and preventative health services, said the changes will give “Albertans more choices” and reduce “unnecessary barriers” to care.
Dr. Sophia Leung, president of the Alberta Association of Optometrists, called the decision “a milestone for our profession and for Albertans seeking timely eye care.”
“This is a big moment for optometry in Canada, but more importantly, it’s good news for
patients,” said Dr. Allison Scott, President of the Canadian Association of Optometrists in a news release.
“Albertans will now be able to get more of their eye care right in their optometrist’s
office, without having to see another specialist for certain treatments. It’s a practical
change that will make care easier to access, and we hope other provinces will follow
Alberta’s lead,” added Scott.
However, Mann said there is no evidence of significant access barriers to these procedures in the province. “It’s possible that there are, but we don’t know this,” he said, adding that “the first order of business would be to actually provide some evidence and to study that.”
Alternatives exist ‘that don’t include reducing the training that’s necessary to do surgery’
Alberta is currently the only province in Canada to authorize optometrists to perform these procedures.
Mann says ophthalmology representatives had been in discussions with the government for years and were “always reassured that we would be part of that decision-making process.”
“This announcement came out of the blue,” he said.
Mann called on the government to rescind the decision and return to working collaboratively with both optometry and ophthalmology. He said alternatives exist—including outreach clinics in smaller communities and increased specialist capacity, “that don’t include reducing the training that’s necessary to do surgery.”
“Albertan patients deserve both timely care and quality care,” he said. “They shouldn’t have to choose between the two.”
