VETOES

This bill would allow an optometrist to administer topical ocular
diagnostic pharmaceutical agents (eye drops) for diagnostic
purposes, but not for purposes of treatment. The Board of
Examiners of Optomology would certify a licensed optometrist as
qualified to administer eye drops only upon completion of a Board
approved 70 hour course in pharmacology. The Department of
Health and Mental Hygiene would authorize the specific drugs that
an optometrist may use.

I have received hundreds of letters and telephone calls from both
proponents and opponents of House Bill 619. I am acutely aware
of trie arguments both for and against the bill and I have reached
my decision on this bill only after a very difficult and personal
evaluation of the issues.

Proponents of this bill argue that it is necessary to use topical
ocular diagnostic pharmaceutical agents in order to
satisfactorily examine the interior of the eye. And as the
primary providers of eye care, allowing optometrists to
administer these agents would lead to the early detection of eye
diseases.

The early detection of eye disease is clearly important, but the
question arises as to who is best qualified to administer
pharmaceutical agents. An optometrist receives four years of
education in optometric school that includes a study of
pharmacology. The primary role of the optometrist is to measure
vision, perform retraction, and prescribe glasses and contact
lenses. And while optometrists are well qualified to perform
these services, it is not an adequate substitute for the
intensive training required of an ophthalmologist. An
ophthalmologist is required to. undergo four years of medical
school, one year of internship, and three years of residency
specializing in eye pathology. During this period, an
ophthalmologist may treat thousands of patients with general eye
diseases. In addition, ophthalmologists are medically trained to
detect subtle ocular symptoms of neurological disorders,
impending stroke, or other systemic body diseases that could be
overlooked by a person lacking the appropriate medical
background.

Although I recognize that this bill has been characterized as a
turf battle between optometrists and ophthalmologists, I have
been impressed by the number of members in the General Assembly
and prominent representatives in the medical community that have
asked me to veto this bill. I have received veto requests not
only from the Maryland Society of Eye Physicians and Surgeons and
the American Academy of Ophthalmology, but also from the Maryland
Chapter of the American Academy of Pediatrics, Maryland
Neurological Society, Maryland Radiological Society, and the
world renowned Wilmer Ophthalmological Institute, which has on
its staff both optometrists and ophthalmologists. This
impressive list of opponents have argued that the enactment of

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