Thanks to changes in Massachusetts law, Vineyard Haven optometrist Dr. Ryan Shea is now treating glaucoma at his practice.
Dr. Shea said treatment of glaucoma by optometrists was a common practice in other states, but Massachusetts had been slow to cede any authority from opthamologists.
“Up until 2021, it just kept getting shut down at the state level,” Dr. Shea said. “We would always make it to a final session, and then the bill would get squashed or overlooked. And in 2021, because of COVID, Governor Baker had a huge healthcare bill, the telehealth bill, which was designed to increase access to care, improve telemedicine, and allow nurse practitioners more treatment levels, and we got included in that bill because it was pretty evident that people needed more access to care for things like glaucoma and other eye diseases.”
Dr. Shea said there are many more optometrists in Massachusetts than there are opthamologists. The basic difference between the two is that ophthalmologists go to medical school and optometrists go to optometrist school, he said.
Dr. Shea said glaucoma is “technically a neuropathy,” which means if untreated, it damages, deadens, and ultimately kills the optic nerve. Dr. Shea said glaucoma stems from too much pressure in the eye bearing down on the optic nerve. The most common reasons for glaucoma are poor drainage of eye fluid, or production of too much eye fluid, Dr. Shea said.
“People who have rheumatoid arthritis can be at higher risk for glaucoma,” Dr. Shea said.
Eye drops are commonly used to treat glaucoma, Dr. Shea said. There are also implant and laser procedures, though he doesn’t do such surgery in his office.
Previously, Dr. Shea said, his office would conduct all the tests for glaucoma and then refer a patient to an off-Island ophthalmologist, even if just for a prescription. “So the ophthalmologist would do an assessment largely based on our test results, and say, ‘Yeah, yeah, he’s right. Here, we’ll put you on drops.’ So it created a huge burden for patients.”
I was pleased to read that an island Optometrist is providing medical treatment for glaucoma, but Mr. Saltzberg’s article doesn’t completely explain the difference in training between an Optometrist and an Ophthalmologist. An Optometrist must graduate from a four year school of Optometry, but an Ophthalmologist must go to medical school for four years and then complete a year of internship followed by a three year residency program in Ophthalmology. An Ophthalmologist is an M.D. and can perform eye surgeries.
We still have to go off-island for cataract surgery. And we can’t drive ourselves. The island sorely needs a resident ophthalmologist, and while I’m at it, a resident dermatologist, too. The aging population finds it a hardship to go off-island for treatments and specialists that many of us require. Housing again? Why can we get thousands of people to come here for music and food festivals, but we can’t get a dermatologist or ophthalmologist to live and practice here?
Meanwhile, Dr Shea is highly regarded for his excellence and thoroughness by off-island ophthalmologists and by his patients. This is very good news for glaucoma patients.
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