New VA Directive

On December 17, 2004, the Veterans Health Administration issued a new directive (VHA Directive 2004-070) that specifies that only ophthalmologists will be privileged to perform therapeutic laser procedures in VA medical facilities. VHA Directive 2004-045, which provided that optometrists could perform these procedures under the supervision of an ophthalmologist, was rescinded.

“Patient safety is paramount,” said Priscilla Arnold, MD, President of the American Society of Cataract and Refractive Surgery. “The position of state and federal regulatory authorities has been to restrict the performance of surgery to doctors of medicine and doctors of osteopathic medicine.  Specific surgical training is mandatory for such privileges. Ophthalmic surgery should be guarded by the same consideration for public safety, and be performed only by those professionals who have been properly trained are licensed to perform surgery,” Arnold added. 

Anthony Principi, the Secretary of Veterans Affairs, wrote that the concerns of other professional medical groups and the inability of the work group established by the VHA to develop a plan to implement the directive that would have allowed optometrists to perform laser eye procedures under the supervision of an ophthalmologist prompted the new directive.  The new directive also prohibits optometrists properly licensed by Oklahoma from performing laser eye surgeries at VA facilities. 

Principi’s comments were contained in a letter to Congressman John Sullivan (R-OK), the lead sponsor of the House bill that would have prohibited optometrists from performing eye surgery in the VA. 

ASCRS worked closely on this important safety issue in a coalition led by the American Academy of Ophthalmology, which included the American Medical Association, the American College of Surgeons, the American Osteopathic Association and the American Academy of Family Physicians. Thanks to all ASCRS and ASOA members who participated in the process by contacting members of Congress and garnering support for our position. The new directive and a copy of the letter to Congressman Sullivan can be found on the ASCRS web site.

Trypan Blue

On December 16, the U.S. Food and Drug Administration announced the approval of Vision Blue (trypan blue ophthalmic solution).  Trypan blue is the first product specifically approved in the US for staining the anterior lens capsule during cataract surgery.

“The approval of the use of Vision Blue augments patient safety because it enables physicians to use a safe and effective ophthalmic solution that will help them reduce the potential for complications associated with mature cataracts,” said ASCRS President Priscilla Arnold.  ASCRS has been advocating for its approval for several years and has been working with D.O.R.C., the manufacturer of the dye, to expedite this process,” she added.