AAOpt 2023: The future of lasers in optometry

Nate Lighthizer, OD, is presenting 3 presentations on lasers in optometry at the 2023 American Academy of Optometry (AAOpt) Meeting: Laser Procedures from the OD to the DO Perspective Part 1: YAG cap and YAG vitreolysis, Laser Procedures from the OD to the DO Perspective Part 2: SLT and Laser PI, and the Laser Learning Workshop.

Video transcript

Emily Kaiser Maharjan, assistant managing editor:
Hi everyone. I'm Emily Kaiser Maharjan with Optometry Times, and I'm sitting down with Dr. Nate Lighthizer, who's presenting presentations on all things lasers for optometrists at the American Academy of Optometry meeting in New Orleans. Welcome! I'm so glad you could join us.

Nate Lighthizer, OD:
Glad to be here, Emily. I'm really looking forward to it.

Kaiser Maharjan:
Yeah. So can you tell us a little bit about the presentations?

Lighthizer:
Yeah, so we have a few of them. "Laser procedures from the OD to the DO perspective," [which is] basically talking about laser procedures. As you know, optometrists have expanded scope over the course of the last 5 to 10 years. There's now currently 10 states where optometrists are performing laser procedures. And the main lasers are YAG capsulotomy, SLT or selective laser trabeculoplasty, laser peripheral iridotomy known as LPI. And then the last one, probably the most rare one, is laser floater removal.

So my good friend, Dr. Leo Skorin, he's an OD DO. [He's] an optometrist and a neuro ophthalmologist, so he's optometrist and ophthalmology. He helped to train me. We thought it would be cool to have a laser procedures from the OD, myself, to the DO perspective as well. So in part one, we're going to cover YAG capsulotomies and YAG laser vitreolysis. And we'll talk about cloudy membranes and the number one laser that optometrists do, extremely rewarding. The tips, the pearls, pre-op, post-op, procedural technique, how do you do YAG capsulotomy, is from the OD to the DO perspective. And then we'll add in YAG laser vitreolysis otherwise known as laser floater removal in that so that's part one, all covering YAG procedures: capsulotomy and vitreolysis.

Part two will be laser procedures from the OD to DO perspective, part two that will talk on glaucoma lasers, which is SLT and laser PI. So how do we utilize lasers in the optometric practice to help our glaucoma patients, whether it's open angle with SLT or narrow angle with laser PI? So again, pre-op, post-op, procedural techniques, how does an optometrist do it? How does an ophthalmologist do it? We'll bounce things off of each other. And this lecture is really made for optometrists that are doing the procedures, but also comanaging. You may be in a state that you're not doing them yet but co.managing. How do you comanage? What are the pearls for that?

And then lastly, we will tie it all together with a hands-on laser learning lab workshop, where we get hands on, we'll have lasers their actual model eyes that are so cool, where they will get hands on with SLT, PI, and YAG lasers, so it'll be a fun time.

Kaiser Maharjan:
So what are some of the key takeaway points that you hope to drive home?

Lighthizer:
Yeah, I hope to drive home that optometry is well qualified to do these procedures; comanage these procedures. We all have different interests. You know, some of us specialize in contact lenses, private practice, the business side, vision therapy, and pediatrics. So not everybody's going to want to do laser procedures. But for those that do, they're well qualified to do these laser privileges. These laser procedures will cover all that hopefully that will drive home that point and it will really open their eyes going: Optometry is well equipped to manage, perform and comanage these procedures.

Kaiser Maharjan:
Absolutely. And how can optometrists leverage this information to better run their practices?

Lighthizer:
Yeah, I think it's just an awareness of knowing when to refer, when to not refer, to know that SLT is now first-line therapy, so better care for our glaucoma patients. There's data from the LiGHT trial that said patients are more likely to progress on glaucoma drops compared to SLT. Well, we don't want our patients to progress. So if they're more likely to progress on drops because of compliance, [it] helps our practice. And how do we better care and manage for our patients by going, "Oh, I should utilize SLT earlier; I should have a capsulotomy here or there, laser floater removal." We all have patients that have floaters and complain of floaters. And our traditional options are pat him on the back observation or vitrectomy, which is pretty invasive. We've got an option in between now. So just an awareness of the procedures that are out there to better care for our patients.

Kaiser Maharjan:
Fantastic. And what do you think the future of lasers in optometry will look like?

Lighthizer:
Yeah, I think the future of lasers in optometry is going to continue to expand. You know, there was only one state, Oklahoma, as short as 13 years ago, and now there's 10 or 11 states. So we're seeing a wave. We know that ophthalmology numbers are static, if not even declining, our population is aging. I envision a future where optometrist will be able to do this in all 50 states. It may take some time to get there, but it's only going to increase. We are incredibly well trained, well positioned to care for our patients locally. So it's a bright future ahead.

Kaiser Maharjan:
Fantastic. Is there anything else that you want to add that we haven't touched on?

Lighthizer:
Yeah, just to encourage people to come and attend. We're gonna have a good time going back and forth with Leo and I on these lectures, laser procedures, and enjoy Academy and we'll see you there.

Kaiser Maharjan:
Fantastic. Well, thank you so much for taking the time to chat today, and it's been so great hearing more about lasers and can't wait to hear more.