CHARLESTON -- One of the most visible disputes in the state Legislature stretched into the final days of the session as lawmakers considered a bill that would give optometrists the ability to perform laser surgery and other minor intrusive procedures.

During the final week of the session, lawmakers in the House of Delegates took up a Senate bill that would expand the scope of services optometrists could provide. The legislation was vigorously opposed by ophthalmologists, who argued it would put patients at risk by putting them in the hands of untrained medical providers.

Optometrists are the specialists most patients see when they need to get new glasses or contact lenses. The field differs from ophthalmology, whose practitioners are doctors who treat eye diseases and are trained to perform eye surgery. Optometrists argue they have the training to perform some minor types of surgery, such as corrective laser surgery.

The fight between the two sides has been a recurring battle during recent legislative sessions. This year it received more media attention than usual thanks to the convoluted path the bill took through the Legislature -- bypassing the Senate Health and Human Resources Committee completely because of concerns by supporters it wouldn't get a fair hearing there.

It didn't manage to get past the House Health and Human Resources Committee, which hosted a March 8 public hearing on the legislation. Roughly 100 supporters and opponents, including a handful of doctors and technicians wearing white lab coats, packed the House floor to watch the debate.

"This bill has built into it many restrictions and safeguards to ensure that our patients are cared for safely," said Dr. Bill Ratcliff of the West Virginia Optometric Association.

Ophthalmologists insist optometrists are not trained to perform the delicate procedures the bill would allow them to do, and as a result it would put patients at risk. They took out advertisements in state media outlets insinuating optometrists are not physicians despite their degrees. Optometrists have labeled those ads as slanderous.

"In my estimation there are no minor surgeries, just minor surgeons," said Dr. Carlos Jiminez of the West Virginia Board of Medicine.

Senate Bill 230 would allow optometrists to use lasers to treat glaucoma and cataracts. It would also allow them to perform injections and prescribe certain medications.

Opponents noted that most states do not allow the types of procedures permitted under the bill, for what they said was a good reason.

"The laser procedures that are listed in this bill can be potentially blinding," said Dr. Edgar Gamponia of the West Virginia Academy of Ophthalmology.

Supporters say ophthalmologists exaggerate the risks, noting they have no data to back up their claims despite the fact Oklahoma has allowed optometrists to perform some forms of corrective laser eye surgery for years.

"In Oklahoma, we still have the lowest rates of professional liability insurance in the United States," said Dr. David Cockrell, an Oklahoma optometrist who is a member of the American Optometric Association Board of Trustees.

The cost of services was another point of contention. Optometrists say they could deliver the same services that ophthalmologists now provide at lower cost.

Committee member Delegate Jonathan Miller, R-Berkeley, pointed to a report by the Cato Institute, a libertarian think tank, that examined several peer-reviewed studies and found the quality of services the public received from non-physician services was often delivered at lower cost and just as safe.

The committee didn't take immediate action on the legislation, instead adjurning for the day. It passed the bill the next day but took out the provision giving optometrists the ability to perform laser surgery.