July 27, 2019 | POSTED BY | Articles, News, Scope of Practice
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Optometry in Paradise

The Aloha State

Have you ever thought about practicing optometry in a tropical paradise? The state of Hawaii is an archipelago comprised of 137 total islands, eight of which are the main islands that are home to a population of over 1.3 million people. Hawaii’s main industry is tourism, and the state capitalizes on its abundance of natural scenery, tropical climate, public beaches, and rich native culture. It’s no surprise that Hawaii provides a great environment for optometric practice.

Living in Hawaii

Although Hawaii is beautiful, many optometrists hold reservations about settling down in the area. While the state has one of the highest median wages, the cost of living has consistently surpassed other states. The high cost of living is largely driven by the need for imported goods into the island. Additionally, Hawaii has one of the highest tax rates in the country, further contributing to the higher cost of living. Financial experts often compare Hawaii to California when looking at the direct correlation between salary and required expenditure in both states.

Optometric Practice in Hawaii

Hawaii is experiencing a shortage of doctors, and that includes optometrists. Given this shortage of practicing optometrists, there is also a large demand for eye care. Between the low-income and rural communities, there is a lack of awareness for the importance of getting routine eye exams. Despite having a low rate of obesity, the Hawaiian population has a high rate of diabetes. Additionally, diabetes is a cause of blindness and low vision, and diabetic retinopathy is known to have been treated earlier with routine comprehensive eye exams.

Hawaii Scope of Optometric Practice

In Hawaii, optometrists CAN:

  • Diagnose and treat glaucoma with topical and oral drugs
  • Co-manage post-operative care
  • Order laboratory tests required for the examination, diagnosis, and treatment of a disease or condition related to the human eye, eyelids, and visual system
  • Prescribe or administer orthoptic therapy (vision therapy)
  • Prescribing, fitting, and adaptation of any corrective lenses for relief from anomalies of the human eye
  • Administer medications by injection for anaphylaxis, including subcutaneous infiltrative, intralesional, intramuscular, and subconjunctival routes
  • Perform minor surgical procedures (including scalpel usage, suturing, and injectable local anesthetic usage) to correct ocular abnormalities in the anterior segment of the eye above Bowman’s layer.
  • Prescribe oral medications including Schedules II (hydrocodone-combination products), III, IV, and V drugs
  • Prescribe and use oral steroids

In Hawaii, Optometrists CANNOT:

  • Perform cataract extractions, retinal surgery, or refractive surgery (such as LASIK)
  • Perform laser or non-laser injections into the posterior chamber of the eye to treat any macular or retinal disease
  • Perform anterior segment laser procedures including YAG capsulotomies, SLT, and LPIs
  • Administer general anesthesia
  • Administer IV medication
  • Administer injectable agents for uses other than anaphylaxis

There is no doubt that Hawaii offers a large scope of practice for optometric physicians. Because of Hawaii’s rural island topography, the demand for medical eye care is outstanding. If you can see yourself being an optometrist in the island paradise of Hawaii, it is imperative to get active in advocacy. As of 2019, there have not been any recent legislations for scope expansion in the state of Hawaii. Joining the Hawaiian Optometric Association can help you protect your rights and advocate for future practice.

Learn more about scope of practice in your state here.