One of the angriest confrontations of the 3-week-old General Assembly session occurred yesterday - and the issue was not abortion, ERA or parimutuel betting - it was eyedrops.
On the one hand were the optometrists, who want the state to permit them to use eyedrops in their examinations, and on the other were the ophthalmologists, or eye specialists, who say optometrists aren't qualified to administer chemical agents. Eyedrops are a form of drug.
"It's an injustice to the patient that you can't use all the tools that you have available," said Dr. Joseph C. Toland, both an eye doctor and optometrist, in arguing for optometrists. He and other supporters of the eyedrop bill said optometrists could conduct more thorough exams, and detect more disease, if they could anesthesize the eye with drugs.
The ophthalmologists contended that the drugs used in eye examinations are so dangerous that they can cause side effects that, in the words of Dr. Harry B. Taylor, representing the Virginia Society of Ophthalmology, "run the gamut from convulsions, psychotric reacts and seizures all the way to cardiac arrests." Only a medical doctor, Taylor and other ophthalmologists argued, is qualified to administer these drugs.
Optometrists, who treat visions problems and prescribe lenses, are not medical doctors.
From both sides of the room (the eye doctors see on one side, the optometrists on the other) during yesterday's hearing came boos, cheers, grumbles and snickers, depending on which side was denouncing the other. At times, the large hearing room - so crowded that spectators were lined up against the long, semicircular wall - sounded like ringside at a Muhammad Ali-Ken Norton fight.
When Dr. Gerald H. Holman, dean of the Eastern Virginia Medical School appearing for the ophthalmologists, said that a recently inaugurated program to train optometrists in pharmacology was inadequate, the eye doctors broke into applause.
After Dr. Harry R. Taylor, representing the Virginia Society of Ophthalmology, acknowledged to Del. Evelyn M. Hailey (D-Norfolk) that some of the patients who died of side reactions to eyedrops were being treated by eye doctors, the optometrists broke into applause.
Back and forth it went during the morning and afternoon, ending only when Chairman John D. Gray (D-Hampton) of the Health, Welfare and Institutions Committee adjourned the meeting to make way for a hearing by the House Education Committee.
To Gray, who said he might favor letting optometrists, "under certain restrictive conditions," use eyedrops, the battle is over "turf."
Dr. Lowell Bellin, former health commissioner of New York City and now professor of public health at Columbia University, put the issue more graphically in his testimony on behalf of the optometrists:
"The general physician and the gynecologist fight over who owns the uterus. The podiatrists own corns and calluses, but are moving up the leg. Orthopedists are moving out to the thigh. This is an economic battle, it it a battle over who shall make money on a certain part of the anatomy - the eye."
Bellin said there is an overall trend in health care to redistribute the responsibilities of each profession - all in the interest of the patient. "We can go into field after field where specialties have been transferred to other groups who have carried them out quite well."
He said nurses, for example, are permitted to administer drugs and intravenous transfusions, when previously only physicians had those responsibilities.
The eye doctors are angry because they think the bill, sponsored by Del. Frank M. Slayton would permit optometrists to diagnose disease, a function not expressly excluded in their present licensing authority.
The optometrist-ophthatmologist battle has been going on in many other states - 20 of which permit optometrists to use drugs in their examinations.