Newborn Eye Protection at Stake in WVa

HOT TOPIC

WVa House Bill Could Invite Preventable Blindness in Infants

Prevent Blindness, a national organization focused on vision health, has raised serious concerns about West Virginia House Bill 3444, which eliminates the state’s mandate for administering antibiotic eye ointment to newborns to prevent ophthalmia neonatorum, a condition that can lead to blindness if untreated. The bill, passed by the West Virginia Senate on April 10, 2025, and earlier by the House of Delegates, does not ban the ointment, but removes the legal requirement for its use, prompting warnings from medical professionals and advocacy groups about potential increases in infant blindness.

The ointment, typically erythromycin, prevents bacterial infections such as gonorrhea-related conjunctivitis, which can be contracted during birth and cause severe vision loss or life-threatening complications if not treated. Prevent Blindness argues that without the mandate, some health care providers may skip the treatment, particularly in cases where parents are unaware of the risks or elect to decline it, disproportionately affecting vulnerable populations with limited health care access. The organization cites data showing that such preventive measures have significantly reduced blindness from ophthalmia neonatorum in states with consistent mandates. Critics of the bill, including pediatricians, optometrists, and ophthalmologists, emphasize that the treatment has been safe, effective, and a standard of care for decades, with minimal risks compared with the severe consequences of untreated infections.

Supporters of the bill argue that it preserves parental choice, but Prevent Blindness counters the idea that informed consent can be maintained without eliminating the mandate. The organization is urging West Virginia residents to contact Governor Jim Justice to veto the bill, warning that its passage could reverse decades of progress in preventing avoidable childhood blindness and place an unnecessary burden on families and on the health care system.

My Two Cents

I don’t even pretend to understand politics. Why exactly would a mandate such as this ever be eliminated? It’s easy and obviously extremely effective. Not to mention, erythromycin ointment is not exactly a drain on the health care system. Goodrx.com shows the cash price to the public is ~$8.00. I can’t imagine what the cost to a hospital complex would be—likely pennies. Although I haven’t done an extensive amount of research, count me in as a probable critic of the bill!

OUTSIDE THE LANE

Study Ties Potential Cancer Risk to CT Scans

A recent study published in JAMA Internal Medicine highlights the potential cancer risks associated with CT scans, estimating that the 93 million CT scans performed in the United States in 2023 could lead to approximately 103,000 future cancer cases, accounting for about 5% of annual cancer diagnoses. The study, led by radiologist Rebecca Smith-Bindman, MD, attributes this risk to the ionizing radiation used in CT scans, a known carcinogen, with the largest number of projected cancers linked to abdomen and pelvis scans in adults and head scans in children. Children, particularly those under the age of 1 year, face a higher risk due to their sensitivity to radiation and longer lifespan for cancer to develop. The researchers emphasize that while CT scans are vital for diagnosing conditions such as heart disease, blood clots, and certain cancers, their overuse or unnecessarily high radiation doses could be mitigated to reduce risks. They advocate for lower-intensity scans or alternative imaging methods such as ultrasounds or MRIs when clinically appropriate, and for informed discussions between patients and doctors to weigh benefits against risks.

The study compares CT-related cancer risks with other significant factors such as alcohol consumption and obesity, urging reforms to standardize radiation doses and reduce unnecessary scans. Despite these concerns, experts note that for individual patients, the benefits of clinically justified CT scans typically outweigh the small risk, but population-wide effects warrant caution.

My Two Cents

Five percent of future cancer diagnoses could be attributed to CT scans! That is a wild stat to read about. Obviously, CT scans are necessary in many situations; however, just as with most things in medicine, the cost-to-benefit ratio should always be weighed. Remember what every doctor should always consider: First, do no harm.

CAN YOU RELATE

One night this past week, I was doing my usual CTI (cruising the internet), when I stumbled across a short piece from Randall Thomas, OD, MPH, on modernod.com. Anything by Dr. Thomas or his equally amazing counterpart, Ron Melton, OD, I consider mandatory reading. Those two doctors first garnered my attention as an optometry student when I started to read their periodical insert, “Clinical Guide to Ophthalmic Drugs,” and I quickly understood that what they said is basically optometric gospel. Speaking of which, please bring that insert back or their more modern “Clinical Perspectives on Patient Care,” which I believe was last published in 2022. Quite a bit has changed, Drs. Melton and Thomas! I’d love your thoughts on all the new updates, drugs, and studies!

Anywho, back to my main point. In Dr. Thomas’ recent piece, “The Trouble With the Term ‘ECP’” on modernod.com, he argues that using the term eye care provider (ECP) in optometry can undermine our profession’s expertise and identity. He also asserts that ECP is overly broad and groups ODs in the same bucket as ophthalmologists, opticians, and others, which dilutes our specific skills and training as optometrists.

Dr. Thomas is very much correct in his argument, and honestly, I had not thought of the use of ECP in this way before. Since reading his article, I have made a concerted effort to use the term ECP less in my lectures and writings. We know that the precise terminology used in public and professional forums shapes professional identity and public perception. Referring to ourselves as optometrists versus ECPs allows our profession to better communicate our advanced capabilities, which aligns with our efforts to elevate our status in health care. Or, better yet, here’s my proposal: Let’s start calling ourselves what we are: optometric physicians. This, in my opinion, reflects the medical nature of the modern optometric practice and better captures the evolution of our profession into its current (and future) role of delivering primary and specialized eye care.

I think the “seasoned” doctor up there in North Carolina is onto something. Once again, great job, Dr. Thomas, for helping steer our profession in the right direction by instigating the right type of conversations!