Expanding Scope: New Optometry Surgical Fellowship

In 1901 when Minnesota became the first state to recognize and legislate the scope of practice for optometrists, ocular healthcare was quite different than today.  As technology has changed and improved to provide safer, faster, and more efficient healthcare solutions, medical providers have had to learn and adopt this new technology to best serve their patient's needs. That's the basis of continuing education hours to maintain  a medical license after all.  But by 1921 when all states in the US had passed legislation recognizing and defining optometric care, the technology that now exists to treat patients could not have been dreamed of or planned for to be written into those original defining laws.  That is the situation that optometry faces now in 2018 where the legislation written in each state that defines the practice of ocular healthcare is now also limiting how the profession can best serve patients. 

Dr. Joanna Bomkamp Gerhardt training on the YAG Laser at the Southern College of Optometry.  Training for minor surgical and laser procedures is a standard part of optometry school curriculum, but the ability to perform these procedures that were taught in school is legislated state by state.  via

State by state, legislation is being brought forward to expand the role and scope of doctors of optometry to include out-patient lid lesion removal and laser-assisted treatments for glaucoma and post-cataract surgery care. Oklahoma, Louisiana, and Kentucky all currently have legislation providing doctors of optometry the right to use technology considered standard of care for conditions they are trained and educated to treat (like glaucoma and eyelid lesion removal).  But with dozens of other states preparing to expand scope of practice laws similarly, the question often posed by legislators or opposing factions has been what standard of training exists to educate optometrists and optometry school students to proficiently perform these out-patient surgical procedures?  

This question sparked The Rosenberg School of Optometry in San Antonio, Texas to create the first ever surgical fellowship in optometry.  “Our goal with this fellowship program is to provide optometrists with the best possible preparation for introducing surgical care into their practices,” said Timothy Wingert, O.D., Rosenberg’s Dean. “All optometry schools now train their students to perform surgical procedures, but for doctors who have been in practice a few years and recent graduates seeking advanced training this program will give them the opportunity to perform hundreds of procedures under expert supervision.”

One complication existed to Dr. Wingert's plans.  At this time Texas is not a state where optometry's legislation provides for the practice of surgical procedures.  To allow their students this important hands-on experience and training, they partnered with Dr. Dennis Golden of Golden Eye Associates in Logansport, Louisiana where surgical procedures in optometry have been legislated since 2014.  His office provides full scope ocular healthcare, including removal of eyelid lesions, cysts, chalazion, and in office laser procedures for glaucoma (SLT) and post-cataract surgery care (YAG laser capsulotomy).  Dr. Golden is a passionate advocate for optometry's role as a primary eyecare provider.  In his rural community, himself and fellow optometrists are the only local eyecare option for patients in need. “There are no ophthalmologists around here.” explained Golden. “The closest ophthalmologist is over an hour away, and many of my patients have no means to get there.”

Dr. Katherine Dronka was the first ever surgical fellowship program participant.  She was a 2016 graduate of the InterAmerican School of Optometry in Puerto Rico and had already completed a residency in ocular disease at the John D. Dingell VA Hospital in Detroit, Michigan.  She was drawn to pursuing the additional 12 month fellowship program because she recognized the impact that surgical procedures would have on the future of eyecare.  "This is an incredibly important program as our profession moves to more medical care," Dronka explained. "Gone are the days that 'one or two' provide fully for our patient's needs."  

Dr. Katherine Dronka

The surgical fellowship is a 12 month program beginning July 1st with a focus on in-patient experience as well as supervising and training optometry school students rotating from the Rosenberg School of Optometry for instruction on state of the art surgical techniques.  Dr. Dronka has had extensive opportunities to grow her skills through both primary patient care at Golden Eye Associates, as well as in nursing home care, emergency calls, and through providing care with local hospital privileges.  "This fellowship has exceeded my expectations.  To date I have performed hundreds of procedures, including iridotomies, capsulotomies, lump and bump removals and periocular surgeries.”

While the fellowship is not yet accredited (it is the very first of it's kind), Dr. Dronka has already benefited with career opportunities through her year of surgical training as well. This fall she'll be joining the University of Pikeville School of Optometry as their new Professor of Surgery.  She's inspired to serve in training the next generation of optometrists on the techniques, procedures, and technology that will be essential to providing ocular healthcare for generations to come.  

The Rosenberg School of Optometry is accepting applications for the 2018-2019 surgical fellowship until April 1st, 2018.  You can learn more here or by reaching out to the program coordinator, Dr. Kyle Sandberg at ksandber@uiwtx.edu.