The year is 2025. Ten states permit optometrists to perform laser procedures like SLT and posterior capsulotomy, and 23 have given ODs the right to excise lid lesions. Use of injectable drugs is widely permitted and collagen crosslinking is the hot new growth opportunity. All across America, optometrists are using lasers, blades and syringes routinely and uneventfully. The scare-tactic stories the medical lobby once used to push back against optometric progress proved to be just that—stories.

Will the next six years play out like this? Hard to say. Prediction is difficult, especially about the future, Niels Bohr famously said. But reading that the American Society of Cataract and Refractive Surgery (ASCRS) has rebranded around advocacy for ophthalmologists got me thinking about the above scenario and the missed opportunity this shift represents.

Most optometrists are still prohibited from becoming members, or attending meetings, of the leading organization for anterior segment surgery; only ODs who work for an ophthalmologist are eligible to play even a limited role in ASCRS. The best source of education on ocular surgeries turns a blind eye to those who arguably need it most, doing a disservice to pretty much everyone, even its own core group of ophthalmic surgeons. Find me a cataract surgeon who doesn’t want to offload pre- and post-op care so they could increase their procedure volume.

Optometry’s legislative infrastructure will only continue to strengthen. Too many inescapable trends point toward it. They’re so well known they hardly bear repeating, but the consequences of growth among both elderly patients and optometrists, while ophthalmology’s numbers stagnate, aren’t hard to suss out. 

Granted, editors fixate on semantics more than most people but I’ve always thought the American Society of Cataract and Refractive Surgery, a name that makes no mention of ophthalmologists, had a unique opportunity to bridge the OD-MD divide. The powers that be could have interpreted that broadly enough to include optometrists, selling it to their established members as a way to help them gain referrals.

Instead, ASCRS saw the future—and flinched, reflexively retreating to its base. At its recent annual meeting, the group unveiled a new slogan: “For Surgeons. For You.” The press release explains that “ASCRS is eager to advance its reputation as the home to all anterior segment surgeons at every career stage and across all associated subspecialties.”

Psst, ASCRS: optometrists are anterior segment surgeons now, too. Not all by a long shot, and their work is limited to a handful of office-based procedures, but a good number of ODs already fit the bill and their ranks will only grow. Trouble is, yours won’t.

And so once again a chance for mutual benefit between the professions goes wanting. Better luck next time. All eyes on you, American Glaucoma Society. Who do you think will benefit most from all those new AI-powered diagnostic technologies in the pipeline?