04/10/2025

Tips from the Trenches - Why Organized Optometry Matters 

Opinion from Immediate Past President Lindsay Florkey, OD, MS 

I have been an optometrist for a little over 20 years. This amount of passing time makes one feel a little nostalgic and sentimental. I am grateful for this profession and all it has given to me, and I am sure that most members feel, as I do, that the profession has given you more than what you have given to it. I have recently spent too much time on social media and I am discouraged by the negative comments about our profession, specifically regarding organized optometry. Many optometrists say they have no need for organized optometry, that it doesn’t help them or speak for them. This idea made me reflect on how different optometry would be today without the AOA/OOA’s efforts over the last 20 years.  

SCOPE OF PRACTICE 
Without organized optometry, my ability to prescribe drugs for ocular conditions would be significantly limited. Seventeen years ago, thanks to efforts by the OOA, we were able to remove the restrictive formulary thus allowing Ohio ODs the ability to prescribe any necessary anti-infective, anti-glaucoma, anti-allergy, and analgesic medications for eye conditions. Can you imagine not being able to prescribe any glaucoma medication that comes onto the market?  

Through this legislation, I also have the ability to obtain a DEA license and prescribe opioids for short durations as needed. I can use an epi-pen in office for cases of anaphylactic shock. I can measure blood glucose in the office, if I suspect diabetes or want to verify the blood glucose reading of a patient. I also can prescribe methylprednisolone for allergic dermatitis, which I have done many times. Thanks to OOA’s advocacy, my abilities in day-to-day practice were modernized. 

THIRD PARTY 
It has been my experience that rather heated emotions can arise when discussing vision plans with optometrists. Whichever side of the fence you land, we practice daily in the world of VBMs. Recently, Arkansas and Texas both passed very aggressive laws against vision plans, but we cannot forget that Ohio was one of the first states to tackle the issue of vision plan abuses with HB156 in 2018. We were able to put into law protections against discounts for non-covered services, lab choice, and prohibiting plans from denying access to a medical plan when not taking the vision counterpart. Texas is facing a very long and expensive legal battle to try and get their law enacted. We will have to see what happens in Arkansas. While our law is not perfect, it was a great first step. Passing HB156 in 2018 in a state like Ohio was monumental, and a hand-up in the planning for the DOC Access Act legislation that the AOA is currently pursuing federally.  

In the last few years, there have been many issues with third-party payors. Anthem and Aetna have instituted down-coding programs, CareSource ceased covering refractions and applied claw-backs to some practices. Aetna was denying access to medical panels when a doctor dropped EyeMed, and multiple plans have been denying medically necessary contact lenses. Organized optometry has been going to bat for optometrists for all these issues and will continue representing optometrists. 

SALES TAX AND THE ABILTY TO SELF GOVERN 
Can you imagine having to charge and collect sales tax for glasses and contact lenses? We would still be doing that today if it was not for the action of the OOA in 2018 pushing for SB8 which eliminated the state sales tax on prescriptive eyewear effective July 1, 2019. This was a tremendous cost savings for our patients and eliminated a huge accounting burden for private practice owners. My patients still comment on how grateful they are for this change. 

In 2017, Governor Kasich wanted to eliminate and consolidate about a dozen state licensing boards, including optometry. If it were not for the major advocacy efforts of the OOA, our profession would have been governed by a health care super-board that included audiology, podiatry, opticians, and estheticians and placed under the medical board. This would have surely prevented any advancement of our profession in the future. Thanks to the OOA and like-minded organizations, the State Board of Optometry was converted into the Vision Professionals Board, which holds a majority of optometrist members, allowing us to remain an independent profession. I would never want a non-optometrist to dictate what I can and cannot do for my patients.  

REGULATORY GUIDANCE 
When COVID-19 hit, many of us were scrambling and very unsure of what to do next. The AOA and OOA were there to provide guidelines, up-to-date information, and to explain the assistance programs that came from the government. I am not sure that my business would have survived if I did not have the information and guidance from the OOA and AOA. 

I think it is clear to see that optometry would be very different without the efforts of the OOA and AOA. We do not operate in a perfect world, but I choose to be grateful for my profession. For those that are displeased with the direction of organized optometry, I suggest that they become an active member of their association. Our profession is only as strong as we make it. Let your voice be heard in a constructive fashion, not just on social media. Attend an OOA Zone meeting or other event, volunteer for an OOA committee, serve as a zone volunteer, donate to OOPAC, read your Perspectives emails, or run for a board position. You may feel more empowered and better equipped to make a positive difference, allowing you to continue caring for the patients you have worked so hard to serve.  

Lindsay Florkey, OD, MS 
Immediate Past President  
Ohio Optometric Association