Optometrists Get Hands-On Experience With Lasers at SECO

Laser therapy has been effective in treating patients with glaucoma in the past, making getting experience with the therapies important for optometrists in an effort to further help their patients. Nate Lighthizer, OD, FAAO, dean at the Northeastern State University Oklahoma College of Optometry, discusses how a hands-on session was conducted at the Southeastern Educational Congress of Optometry (SECO) 2025 meeting, held from February 27 to March 2, 2025, in Atlanta, Georgia. He also addresses the benefits of using laser and the challenges regarding accessibility.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

Can you talk about the SECO showcase that you helped lead?

This is the SECO Anterior Segment Showcase. SECO is really always on the cutting edge of technology and bringing in technology into a couple of workshops, both anterior segment and posterior segment. The last 2 hours, we've been doing the anterior segment workshop, so we had companies obviously focused in the anterior segment. We had companies like Nidek for lasers and SLT [selective laser trabeculoplasty], which is an anterior segment laser, anterior segment imaging, OCT [optical coherence tomography], radio frequency, cosmetics, [and] even things like glasses that you can wear that can amplify the sound to help assist with hearing aids.

Everything kind of focused on anterior segment, new technology. We talked on it for about 30 minutes, Chris Wroten [Chris Wroten, OD, Southern College of Optometry] and I, to introduce it to the attendees. Then the fun part is we broke them up into groups of 7, and they rotated and spent 10 minutes at each station, and actually got hands-on experience with lasers, IPL [intense pulse light], radio frequency, OCT, [and] all of this technology. It was really fun for the attendees to enjoy.

How has laser therapy shaped glaucoma treatment?

Especially when it comes to glaucoma, SLT helps to ease that treatment burden on patients. Historically it's been, take this drop, take a second drop, take maybe even a third drop, and that is so burdensome to a patient. [They] have to remember morning, afternoon, evening, to take a drop or 2 or 3. SLT helps to ease that burden. We know from studies like the SLT-MED study and the LiGHT trial [NCT03395535] that SLT patients are less likely to progress over 6 years vs on drops, and we know the main factor that is compliance. If you're not taking your drop, you're not compliant, your pressure is going to go up, and you're more likely to progress.

So helping to ease some of that burden with the patient, a concept of interventional glaucoma. I'm a big believer in interventional glaucoma and even interventional dry eye. Take some of that out of the patient's hands. Let's do it in the office. Maybe it's IPL, radio frequency, thermal devices in the lids for dry eye, but SLT, MIGs [microinvasive glaucoma surgeries], drug delivery, and glaucoma, let's ease some of that burden off of patients.

What are some challenges in the accessibility of laser treatment for patients?

One of the biggest challenges is the laws that limit what optometrists do in terms of scope of practice. There's currently only 12 states that authorize optometrists to do laser procedures, so 38 don't allow that. That is a burden. A patient in rural North Dakota would have to be referred to an ophthalmologist that may be an hour away, 2 hours away, 3-month wait, 6-month wait, or longer. The biggest hurdle is optometry not being able to do it in 38 states. It would be a huge public health win, in my opinion, if optometrists were authorized to do SLT, because it's a first-line therapy, and who treats glaucoma first line? Optometrists do.