Patient experiences of laser and surgical lid procedures performed by optometrists

Optometrists are authorised to perform YAG capsulotomy, selective laser trabeculoplasty, and laser peripheral iridotomy in various jurisdictions within the United States. Modernised scope of practice evolved in response to the ageing population, ophthalmology workforce shortage and maldistribution, and the need for increased access to eye care. However, there is a paucity of literature on the experiences of patients who have had laser and surgical procedures performed by optometrists.

This study explores the experiences of patients who underwent laser and surgical lid procedures performed by optometrists. It also investigates perceptions of care, barriers, and enablers to access.

Semi-structured interviews were conducted with patients who underwent in-office procedures performed by optometrists affiliated with the Northeastern State University College of Optometry clinics across Oklahoma. A qualitative descriptive approach was used and the interview guide included open-ended questions that sought to understand patient experiences and access to care. The interviews were conducted up to three months post-procedure. The transcripts were manually cleaned and de-identified, and thematic analysis and coding were conducted by two independent researchers using NVivo.

Thirty patients including 20 females and 10 males participated in the study. The procedures included selective laser trabeculoplasty (n = 8), laser capsulotomy (n = 8), laser vitreolysis (n = 4), and surgical lid procedures (n = 10). Four major themes were identified including access to care, expectations, person-centred care, and quality of life improvement. Participants felt confident in the optometrists' ability to deliver procedures safely and effectively.

Participants reported that optometrists performing advanced procedures enabled access to quality, person-centred care. These outcomes, alongside robust clinical and safety data in the literature, support the provision of advanced procedures by optometrists. As such, there is a compelling rationale for other US states and international jurisdictions to consider similar healthcare frameworks.