By Jennifer Nunez

When it comes to something as precious and irreplaceable as eyesight, there is no room for uncertainty, no room for shortcuts, and no room for error.

That’s why Governor Kelly Ayotte made the right decision in vetoing House Bill 349, legislation that would have allowed optometrists to perform laser eye surgeries in New Hampshire.

As Granite Staters navigate the realities of aging, encounters with new doctors, unexpected diagnoses, and medical treatments become increasingly common. These moments often arrive without warning, bringing urgent and unfamiliar questions: Who do I need to see? Is What surgery procedure is required? Are there non-surgical treatments?  What comes next? In that uncertainty, patients place profound trust in the medical community. Residents rely on New Hampshire’s medical and surgical community to be fully vetted, highly trained professionals and true experts in their fields, especially when facing something as serious as eye surgery.

Whether the need is surgery treatment for glaucoma, cataracts, or treatment for other age-related eye conditions, patients expect that the person operating on them performing such procedures possesses the highest level of medical education, training, skill, and experience. This expectation is not excessive; it is essential. The human eye is extraordinarily delicate, and when something goes wrong, the consequences can be permanent and life-altering.

That is why maintaining the highest standards for education and training in eye surgery is so critical. When individuals are faced with an eye surgery diagnosis, they must be able to place complete trust and confidence in the qualifications and expertise of the medical professionals who are caring for them.

In conversations I’ve had with other caregivers, parents, families, and policymakers across New Hampshire, the reaction has been consistent. People are uneasy with the idea of non-physicians performing eye surgery. surgical eye procedures. And that instinct comes from a place of common sense. We all understand, intuitively, that surgical readiness only comes from the highest level of medical education, professional training, and quality standards.

This is not about diminishing the important role optometrists play. They are a vital part of our healthcare system. They care for patients every day providing exams, prescribing lenses, and treating many visual conditions. Families rely on them, and for good reasons.  But they are not medical doctors or trained surgeons.

But there is a clear and important difference between basic primary vision care and performing eye surgery.  Ophthalmologists are medical doctors who specialize in eye surgery, completing medical school, surgical residencies, and years of hands-on training before they operate independently. That level of medical training exists because surgery demands it, and Granite Staters should expect nothing less.

HB 349 would have blurred that line in a way that puts patients at risk but allowing optometrists to perform certain types of surgery inside the eye.

Perhaps most concerning is the question of education training. Medical school provides the necessary foundation required to embark on a surgical residency program.  This is simply not achievable in optometry school.  The overwhelming majority of optometry schools in the United States are located in states that do not allow optometrists to perform laser eye surgery. That raises an important question for any caregiver or patient: where is the hands-on surgical experience coming from? The answer is unclear and when it comes to our health, “unclear” isn’t good enough.

Here in New Hampshire, this issue comes down to something simple: patient safety. No state in the Northeast allows optometrists to perform laser eye surgery. That’s not an accident and it reflects a shared, cautious approach grounded in protecting patients first.  As a caregiver, I shouldn’t have to wonder whether the person performing my eye surgery learned their surgical skills through a 32-hour weekend course practicing on prosthetics and models (the standard “surgery” course in optometry school) or the over years of performing hands-on, supervised surgery residency instruction on real patients. Can you imagine having to ask that question before eye surgery is performed on a loved one?

And Granite Staters agree. A recent University of New Hampshire poll found that nearly 80 percent of residents oppose expanding surgical authority in this way. In today’s divided world, it’s rare to find that kind of consensus, but on this issue, people are united.

Governor Ayotte recognized that.

By vetoing HB 349, Governor Ayotte showed she understands what’s really at stake. She chose to put patient safety ahead of the pressure to expand medical roles without the level of education and training that surgery demands. Her decision keeps important safeguards in place, ensuring that when it comes to something as delicate as eye surgery, patients are cared for by those with the highest level of preparation.

At the end of the day, this isn’t about politics or professions. It’s about knowing that when any of us need care, we can trust that eye surgeries are performed by qualified eye surgeons. It’s that simple.

Healthcare innovation and access are important goals, but they should never come at the expense of safety. When it comes to something as precious as sight, caution isn’t obstruction, it’s responsibility.

And as a daughter, mother, and healthcare decision-maker for my family, that’s a standard I believe we should all be able to agree on.

Jennifer Nunez lives in Gilford. She is the former Director of Emergency at LRGHealthcare.