An effort years in the making to expand optometrists’ scope of practice is one step closer to becoming reality after the House Health Professions and Programs Subcommittee cleared a measure Thursday. 

The bill (HB 449) received split-party support. Three of the six committee members who voted against the measure were Democrats, and three were Republicans. Meanwhile, two Democrats voted in favor, and 10 Republicans gave the measure a nod. 

The Committee cleared a committee substitute for the bill, which makes some minor modifications to the original measure but maintains the legislation’s general goal.

Opposed by ophthalmologists, it again seeks to allow optometrists to call themselves Doctors of Optometry (O.D.) or “optometric physicians” in advertisements despite significant differences in medical training and education. 

Ophthalmologists complete medical school and a required residency, which typically represents a decade or more of medical training and more than 17,000 hours of patient contact training before such medical doctors are permitted to practice independently. By contrast, optometrists complete a four-year course in optometry, and not all of the programs require a college degree. The training does not include residency or surgical training.

Sponsored by Rep. Alex Rizo, the bill would, among other provisions, allow an optometrist to advertise themselves as an optometrist, licensed optometrist, doctor of optometry, optometric physician, board-certified optometrist, American Board of Optometry certified, Fellow of the American Academy of Optometry, Fellow of the College of Optometrists in Vision Development, residency-trained, or a diplomate of the American Board of Optometry.

It also includes revisions to existing law that would broaden an optometrist’s scope of practice to include additional surgical procedures and prescribing authority.

The committee substitute further redefines “certified optometrist” to include administering and prescribing ocular pharmaceutical agents, medications used to treat or diagnose eye conditions. It also amends educational and certification requirements for administering ocular pharmaceutical agents and authorized ophthalmic surgeries, including the ability to perform laser and non-laser procedures. However, the bill would not allow an optometrist to perform procedures requiring preoperative medications or drugs that alter consciousness, such as general anesthesia. To be certified for authorized procedures under the bill, optometrists must complete a course and pass an examination successfully. 

Ophthalmologists remain opposed, however. Before the committee substitute passage, the Florida Society of Ophthalmology urged lawmakers to vote down the bill, arguing it would endanger patients by allowing less trained optometrists to perform more advanced procedures. 

“Optometrists play an important role in eye health care, providing essential services such as vision testing, prescribing corrective lenses, and detecting certain eye conditions. However, their scope of practice typically does not include surgical procedures involving lasers, scalpels, or injections on or around the eye. These advanced interventions require the specialized medical education, extensive surgical training, and clinical expertise of ophthalmologists,” said Dr. Raquel Goldhardt, the President of FSO.

FSO pointed to research published in the Journal of the American Medical Association on a type of laser surgery to treat glaucoma. It was found that patients who receive treatment from an optometrist are significantly more likely to require additional surgery. FSO further cited incidents of “sight-threatening complications” following optometrist-administered procedures in other states, including Oklahoma, Louisiana, and Kentucky.

Still, those who support the scope of practice expansion argue it increases access to eye care. However, ophthalmologists say most Floridians live within a 30-minute drive to an ophthalmologist, and there is currently no backlog of patients seeking ophthalmologic care in the state.

Rizo has fired back against the critique. 

“What exactly this bill does (is make it so) you don’t have to go to an ophthalmologist, necessarily, if there’s a condition that calls for this particular procedure or pain medication,” he previously told Florida Politics. “No surgery, nothing like that. It’s basically an advanced first-aid procedure to release inter-corneal pressure.”

Rizo carried a similar bill in 2021, but it and its Senate analog died before reaching a floor vote.

The “eyeball wars” date back years, at least to Sen. Don Gaetz’s reign as Senate President, a leadership role he held from 2012 until 2014.

Gaetz coined the term “eyeball wars,” and in 2013, he believed he resolved the turf war between ophthalmologists and optometrists. The two sides settled on a compromise allowing optometrists to prescribe oral medications but not to perform surgery.

But the fight resurfaced a few years later.

A bill similar to this year’s effort (SB 1112) died last Session after the House and Senate failed to reconcile. Then-Senate President Kathleen Passidomo, whose father was an ophthalmologist, filed priority legislation that would have blocked the use of the term doctor or physician in certain circumstances, including for optometrists.

The House amended the bill to allow optometrists to use the terms in advertisements. Passidomo successfully ushered the measure through (2023’s SB 230), but Gov. Ron DeSantis vetoed it. Rizo voted that year against efforts to allow optometrists to refer to themselves as doctors of optometry.

This year’s measure has one Committee stop remaining before reaching the House floor, the Health and Human Services Committee. 

A Senate companion has not yet been filed.

If passed and signed by the Governor, the measure would take effect July 1.

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Walt Disney Co. CEO Bob Iger got a chance to respond directly to criticism surrounding Disney World fans’ biggest complaints: expensive and crowded theme parks.

Iger answered shareholders for about 10 minutes during Thursday’s annual shareholders meeting. At the meeting, Disney shareholders also rejected two politically loaded shareholder proposals asking the company to withdraw from an LGBT rights organization’s corporate ratings and to study how Disney investments contribute to climate change.

During the Q&A, one shareholder said Disney hasn’t kept up with attendance demands and asked if Disney is also worried that high prices might keep guests from booking a return trip.

Iger acknowledged that the parks are packed.

“In fact, I was just at Walt Disney World on actually a weekday in March, and the place was really busy — really across the whole property,” Iger said.

However, he argued the parks are expanding their capacity. Disney is building a Villains Land at the Magic Kingdom, a Cars attraction that’s controversial with Disney fans, and more in Orlando.

“We have more being designed, developed and built today than at any other point in the 70 years since we’ve been in the theme park business,” Iger said. “We also appreciate that our parks create lifelong memories for families. So with that in mind, we’re constantly considering and developing and implementing new ways to make the experiences that we offer both more enjoyable, but of equal importance, more accessible.”

A one-day ticket at the Magic Kingdom ranges between $149-$169 in March and April, although the company offers discounted multiday tickets at a lower rate for Florida residents.

To keep the parks more accessible, Iger said Disney tripled the number of days that lower priced tickets were available when he returned as CEO two years ago

Could Disney build more international theme parks?

Don’t hold your breath.

“We’re mostly focused on expanding in places that we currently operate,” Iger said when asked about it.

He quickly pivoted to the cruise business for Disney lovers around the world.

“We’ve plenty of opportunities to expand where we currently operate in our cruise ship business.”

Iger was also asked about Figment, the purple dragon appearing on Epcot’s Journey into Imagination ride. Hardcore fans once infamously waited up to seven hours to get a Figment popcorn bucket. That’s how popular the character is.

Can Figment get his own Disney movie?

“This is my 24th shareholder call, my 18th as CEO. And I think the question about Figment has been asked about 15 times. I call him good old Figment,” Iger said.

“I’ll tell you what. I’ve been asked this so many times that I am going to ask our creative teams to consider making some form of series or short-form videos of Figment. Obviously he’s more popular than just a walk-around character in our parks and resorts.”

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