Alaska, the Last Frontier: a Leader in Scope of Practice
For curious future optometrists, Alaska offers a wide variety of patient populations including transplants, local Alaskan families, indigenous populations, as well as military service members.
UMSL College of Optometry graduate Dr. Amber Mayberry took the time to hold an interview about why she chose to move her family north to explore the great state of Alaska.
“If you want to learn an insane amount of information in a short amount of time, Alaska is where you want to be,” she says. “Seriously, it’s like trying to drink water from a fire hose! In a single day, I can go from fitting scleral lenses for a corneal ectasia, to referring a retinal detachment with a vitreous hemorrhage, to removing a corneal foreign body. On top of that, I am managing glaucoma, AMD, and treating dry eye. In the near future, we may be adding an even broader scope of practice that will include SLT and PI procedures to our daily schedule.”
Dr. Mayberry is referring to Alaskan House Bill 103, which officially eliminated the need for the optometry lobby to go to the Alaska State Legislature for statute changes as optometric education and technology advances. Alaskan House Bill 103 gave the Alaska Board of Examiners in Optometry the authority to write regulations allowing doctors of optometry to practice to the highest level of their education- a huge victory in the scope of practice for optometry.
Contrary to popular belief, Alaska is not all igloos and dogsled races. Dr. Mayberry lives in Wasilla, a town of approximately 10,000 people about 45 minutes north of Anchorage. She joked, “There is a Fred Meyer, Target, and Starbucks in Wasilla. What else could you possibly need?” She claims the area has all of the modern amenities of any other American town, “There are normal conveniences like movie theaters, gyms, restaurants, and dog parks. We have a good micro-brewery scene, too!”
But Alaska is not without its pitfalls. Alaska is home to the longest days and nights in the United States. Once the sun rises on May 10th, it will not set until August 11th. That’s 84 days of pure sunlight! On the other hand, the Alaskan winter begins on November 18th . The sun sets and does not rise above the horizon again until Jan 24th– 67 days later!
Because of the lack of healthcare providers within Alaska, both the local towns and the federal government help incentivize jobs for physicians. Many doctors can work for a few years to help pay off loans or start an early retirement. For students looking to help indigenous tribes within Alaska, the state also recognizes the most official languages of any state in the US: English and twenty indigenous languages. Regardless of your reason for moving, you can be sure that Alaska will both excite and surprise you with an enriching optometric experience.
In Alaska, optometrists CAN:
- Prescribe and dispense glasses and contact lenses
- Prescribe and perform orthoptic therapy (vision therapy)
- Administer medications, including anesthetics, by injection, including subcutaneous infiltrative, intralesional, intramuscular, intravenous, and subconjunctival routes
- Perform minor surgical procedures to correct ocular abnormalities, such as removal of “lumps and bumps” around the eye
- Prescribe oral medications, including Schedules II (hydrocodone-combination products), III, IV, and V drugs
- Prescribe oral steroids
- Diagnose and treat glaucoma with topical and oral drugs
- Co-manage post-op care
- Perform procedures such as foreign body removal, dilation and irrigation, punctal occlusion, and eyelash epilation
- Perform anterior segment laser procedures including YAG capsulotomy used to treat cloudy lens implants following cataract surgery, Selective Laser Trabeculoplasty (SLT) and Laser Peripheral Iridotomy (LPI) used to treat some forms of glaucoma
In Alaska, optometrists CANNOT:
- Perform cataract extractions, retinal surgery, or refractive surgery (such as Lasik)
- Laser or nonlaser injection into the posterior chamber of the eye to treat any macular or retinal disease
- Administer general anesthesia
Scopes as expansive as Alaska do not happen without the help of the local and state optometric boards. Victories like HB 103 are due to active engagement in the Alaskan Optometric Association (AKOA). As a legislated profession optometry is dependent on the civic engagement of optometrists and optometry students. For more articles about the optometric scope of practice in other states, click here!