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Vermont Legislature is deciding who should be allowed to do surgery on your eyes

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Vermont Legislature is deciding who should be allowed to do surgery on your eyes


Vermont’s optometrists and ophthalmologists are battling over who is allowed to do surgery on your eyes.

A bill being considered by the Vermont Legislature would allow optometrists to perform certain surgeries that are currently the exclusive purview of ophthalmologists. Ophthalmologists are medical doctors and surgeons, while optometrists are primary eye care providers.

Dean Barcelow, president of the Vermont Optometric Association, explained optometrists complete four years of undergraduate training, followed by four years of graduate training on the eye, earning a Doctor of Optometry.

Dr. Jessica McNally, president of the Vermont Ophthalmological Society, said all ophthalmologists are physicians and surgeons, completing four years of an undergraduate degree program followed by four years of medical school. After medical school, ophthalmologists spend four to six years of residency and fellowship training that can include specialties such as general surgery, emergency medicine and internal medicine, but focuses primarily on advanced medical and surgical treatment of the eye, according to McNally.

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Historically, optometrists have handed off to ophthalmologists for procedures including surgeries, injections and lasers, but that line is being blurred by legislation like that now being considered in Vermont. Recently, South Dakota became the latest state to expand the scope of work for optometrists − as the terminology goes − to include surgeries that previously only ophthalmologists could perform. The argument made by optometrists is that it expands on the in-office procedures they already do, increasing access and lowering costs for patients. The counter-argument made by ophthalmologists is that it’s dangerous, because optometrists don’t have the training or experience required.

What are the procedures and surgeries optometrists would like to do that they can’t do now?

The surgical procedures Vermont optometrists want to add to their wheelhouse can be broken down into three “buckets,” Barcelow said. The first bucket is injections into the “superficial eye,” or the eyelid, not into the eye. Optometrists also want to be able to inject dye into a patient’s veins to look for leaky blood vessels in the eye.

The second bucket is the removal of small, benign lesions, such as skin tags on the eyelid or close to the eyelid. The third bucket, Barcelow said, contains three “very well-defined laser procedures.” The first is related to cataract surgery.

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“When you have cataract surgery they put a new lens in the eye and take the cloudy one out,” he said. “Sometimes six months, sometimes 10 years later a film will grow on the back of that lens and we’ll zap it off with a laser. It takes two to three minutes, or longer if the film is thick or the patient is jumpy.”

The second procedure involves using a laser to add an “emergency drain” to the eye when the natural drain closes up and fluid begins to build up. The third laser procedure also has to do with improving draining by stimulating the tissue that drains the eye to become more efficient, which is particularly useful for glaucoma patients in early stages of the disease, or who can’t take drops, according to Barcelow.

“This isn’t something that’s a giant deviation,” Barcelow said of the procedures. “We already use sharp and scary things around the eye.”

Barcelow accused ophthalmologists of “saber-rattling” to make people nervous.

“Name anybody you would like to come near your eye with a scalpel,” he said.

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Ophthalmologists say the surgeries optometrists want to do are not as easy as they would have you believe

McNally addressed each of Barcelow’s buckets. First bucket: injections into the superficial eye − the eye ball − and the ability to inject dye into patients’ veins to check for leaky blood vessels in the eye.

On the subject of injecting dye to check for leaky blood vessels, called a “fluorescein angiogram,” McNally said the injection often causes nausea and sometimes vomiting and potentially anaphylaxis, a life-threatening allergic reaction.

“I don’t do them in my office,” McNally said of fluorescein angiography. “There’s testing equipment − a camera − that provides similar if not the same results and is widely used by optometrists. We don’t understand why they want to do angiograms.”

With regard to the second bucket, removing small benign lesions in the eye, McNally said the question of whether a lesion is benign is fraught with uncertainty.

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“Optometrists would say they are trained to figure out whether a lesion is benign or malignant and make a decision whether or not to take them off,” McNally said. “Our specialists who take care of eyelid lesions will tell you they’ve been surprised and taken off lesions they thought were benign and were malignant. We’re very concerned about misdiagnosis. One of the things that concerns us is the simplicity with which (Barcelow) presents these lesion removals.”

McNally also contends optometrists underplay the significance of cutting off a lesion near the eye.

“Removing lesions and cysts requires using a scalpel, with sutures afterward, and the potential for unexpected bleeding,” McNally said. “We’ve discussed with the Office of Professional Regulation and legislators that it’s very difficult to anticipate whether or not you’re going to need to place sutures and you have to be ready for that.”

And finally, lasers. McNally said she is very disturbed by the prospect of optometrists, who don’t have the extensive training and experience of using lasers on patients that ophthalmologists have, doing the procedures in Barcelow’s third bucket.

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“The reason these lasers seem quick and easy, as optometrists claim, is because we’re trained to use them, and it’s supposed to be easy for the patient,” McNally said. “It’s not easy for the surgeon doing it. You could do a lot of damage if you don’t do it right because you don’t have the experience.”

State report gives both sides victories, but should the report have been written in the first place?

The Office of Professional Regulation issued a 258-page report requested by legislators on Oct. 31, 2023, that recommended expanding optometrists’ scope of practice to include specific injection and laser and non-laser surgical procedures. OPR qualified that recommendation by saying only optometrists with a “specialty endorsement license” should be permitted to perform these advanced procedures.

To get the specialty endorsement license, optometrists would have to complete a post-degree “preceptorship” − essentially instruction − in performing the advanced procedures on “live, human patients.” Optometrists would also have to pass examinations showing they know how to do the laser and non-laser surgeries and injections.

Finally, optometrists performing these advanced procedures would be required to report the outcomes to OPR biennially, and to report “adverse events” to OPR immediately.

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On the questions of improving access and lowering costs for the procedures optometrists would be able to do, OPR said it was unable to determine whether expanding the scope of practice for optometrists would do either, undermining a key argument optometrists make for taking this step. As a result, both sides claimed victory after the OPR report was issued.

McNally sees a bigger problem with the OPR report. She doesn’t think OPR should have been put in the position of creating the report in the first place.

“How do you assure patients are safe when there’s no standardized surgical training?” she said. “OPR has been forced into this position. They had to make a recommendation based on what they were asked to do. This is what they came up with. I don’t feel they have the medical expertise to make recommendations. Clearly they don’t think optometrists are trained to do these surgeries, or they wouldn’t require them to go for more training.”

Contact Dan D’Ambrosio at 660-1841 or ddambrosi@gannett.com. Follow him on X @DanDambrosioVT.



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Vermont

‘A costly unforced error’: Vermont Legislature’s top economist slams Trump’s trade war – VTDigger

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‘A costly unforced error’: Vermont Legislature’s top economist slams Trump’s trade war – VTDigger


MONTPELIER — The Vermont Legislature’s top economist called President Donald Trump’s trade war with Canada and Trump’s disparaging rhetoric toward the country a “costly unforced error” that is putting pressure on the state’s budget at an already challenging time.

Tom Kavet was speaking to members of the Vermont House and Senate at a briefing Wednesday in Montpelier on some of the major issues legislators will face when they reconvene for the 2026 legislative session, which starts the second week of January.

Kavet said a drop in visitors from Canada this year compared to years past — something that is a direct result of Trump’s actions — has meant less tax revenue is being collected from tourists to support state services. That’s likely to make it harder for legislative leaders, working with Gov. Phil Scott’s administration, to balance the books when they start developing a new state budget next month, Kavet said. 

At the same time, top legislators have already pointed to how rising costs at home and shrinking federal support for key social services could force them to trim other programs and initiatives that residents rely on, though they have not yet proposed specific cuts.

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Traffic at Vermont’s welcome and visitor centers was down 9% between January and mid-November 2025 compared to the same period in 2024, according to data Kavet presented Wednesday. Most of those centers are situated on or near Interstates 89 and 91.

At the centers located closest to Canada — in Alburgh and Derby Line — the drop between those time periods was far higher, about 36%, data shows. At centers located slightly farther south, including in Georgia and Lyndonville, the drop was about 18%.

Meanwhile, data from U.S. Customs and Border Protection shows that traffic into the U.S. at border crossings in Vermont fell below 2024 levels immediately after Trump took office in January 2025, and has remained below 2024 levels every month since.

In October 2025, cross-border traffic — which includes cars, trucks, pedestrians, and airplanes — was down about 22% compared to October 2024, federal data shows. 

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A chart from U.S. Customs and Border Protection showing how traffic into the U.S. at border crossing stations in Vermont has changed over the past three federal fiscal years. Screenshot courtesy of U.S. Customs and Border Protection

Kavet called the decline in cross-border visitors this year “needless.” 

Kavet is the president and co-founder of a Williamstown consulting firm that provides fiscal analyses guiding Vermont’s state budget-building process each year.

“I say needless just because you can apply tariffs on whoever you want, but if you want to rub it in somebody’s face and nose, you’re going to get reactions like this,” he said. “And it just doesn’t help when it comes to revenue that we’re wanting — and needing.”

The decline in traffic comes as Vermont has brought in less tax revenue from hotel room rentals and purchases at restaurants and bars than the state was expecting, Kavet said.

Meals and rooms tax revenue landed about 2% below October targets, according to the latest data from the state Agency of Administration. The amount the state put into its education fund from that same tax was about 4% below officials’ targets, according to the data.

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Meanwhile, between January and the end of October 2025, the data shows meals and rooms tax collections were about 1% lower than they were over the first 10 months of 2024.





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The Latest in Vermont Fundraisers and Holiday Records

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The Latest in Vermont Fundraisers and Holiday Records


Some of the best musicians from the Green Mountains’ folk and bluegrass scene are banding together to help feed hungry Vermonters this winter.

Chad Hollister, Kris Gruen, Bow Thayer and the VT Bluegrass Pioneers headline the FEED VT benefit concert on Sunday, December 21, at the Haybarn Theatre at the Creative Campus at Goddard in Plainfield. Billed as “an inspiring evening of music, community and love to help feed Vermont families in need,” the show funnels all proceeds to the nonprofit Capstone Community Action’s Food Shelf in Barre. The organizers ask attendees to bring nonperishable food items. Find the wish list at capstonevt.org, where you can also follow a link for tickets.

Violet Crimes Credit: Courtesy

Burlington punk band Violet Crimes have joined forces with singer Bri Lucas, formerly of the rock band Embers in Umbra, to release the new single “Don’t Own Me.” The hard-charging pop-punk rager is an anthem for the fight to restore and protect women’s reproductive rights.

“Does my body make you nervous?” Lucas sings on the track. “My autonomy so disturbing? Oh well, you don’t own it.”

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The song came about after Lucas reached out to Violet Crimes singer Amy Klinger. Fueled by the U.S. Supreme Court overturning Roe v. Wade in 2022, they joined forces to write the track with Violet Crimes drummer Jason Dean and recorded it with producer Ryan Cohen at Robot Dog Studio across the lake in Mineville, N.Y.

“I once benefited from medical intervention during a miscarriage,” Lucas wrote in a press release for the single. “I decided to write a punk-rock song about this era of women’s rights and our ongoing struggle for bodily autonomy.”

Lucas wanted to sing with another female vocalist on the track and immediately thought of Klinger and Violet Crimes.

“Working on this song literally and figuratively gives us voice at a time when it’s easy to feel powerless,” Klinger said in the press release. “Plus, having the chance to sing a great, earworm-worthy song with a powerhouse, high energy vocalist like Bri is an absolute privilege.”

All profits from “Don’t Own Me” will be donated to the Center for Reproductive Rights, a global organization. Stream the track at violetcrimesvt.bandcamp.com and watch the making-of video filmed at Robot Dog on YouTube.

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Snow is falling, bells are jingling — you know what time it is. And so do Vermont musicians! The wave of holiday shows and albums has started to roll in.

Kick off the festive month on Thursday, December 4, at Richmond Congregational Church with a performance from bluegrass and jazz act Mr. Sun. The quartet, led by ace fiddler Darol Anger and mandolin virtuoso Joe K. Walsh, performs its interpretation of Duke Ellington’s interpretation of Pyotr Ilyich Tchaikovsky’s The Nutcracker Suite. (Mr. Sun also recorded their version in 2023 at Mass MoCA in North Adams, Mass.) Check out valleystageproductions.com for more information and to purchase tickets.

Burlington band EmaLou & the Beat have dropped an entire new holiday album titled Simple Things. Recorded live last year at Burlington’s Tank Recording Studio — on the winter solstice, no less — the record features classics such as “Let It Snow” and “White Christmas,” alongside originals and new arrangements of traditional tunes. The band celebrates the vinyl release of the record with two holiday shows: Friday, December 12, at the Montpelier Performing Arts Hub and Friday, December 19, at the Venetian Cocktail & Soda Lounge in Burlington. Visit emaloumusic.wordpress.com to learn more.

Bull’s Head, the solo project of folk songwriter Andy Samara, has a new EP out titled Joy to the World. The album features three traditional, public-domain holiday classics; Bob Dylan’s “Must Be Santa”; and Samara’s own original yuletide composition, “Same Light as the Kings.”

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“As a lukewarm fan of Christmas music, and hater of contemporary Christmas originals, it feels fun to release this small collection,” Samara wrote in an email. He compiled the songs after recording them over the years as holiday gifts to friends. Give Joy to the World a listen at bullshead.bandcamp.com.

Listening In

Playlist of Vermont jams





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Trump administration sues Vermont secretary of state for failing to turn over voter data – VTDigger

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Trump administration sues Vermont secretary of state for failing to turn over voter data – VTDigger


Secretary of State Sarah Copeland-Hanzas at the Statehouse in Montpelier on June 18, 2024. Photo by Glenn Russell/VTDigger

The Trump administration has taken Vermont’s secretary of state to court, asking a federal judge to force the state to turn over information on registered voters. 

Filed on Monday in Vermont’s U.S. District Court, the lawsuit argues Secretary of State Sarah Copeland Hanzas violated federal election law when she refused to share registered voters’ addresses, drivers license numbers and the last four digits of their social security numbers, among other information. 

Vermont officials have yet to respond to the suit in court. 

Vermont secretary of state says she won’t share voter data with Trump administrationAdvertisement

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Back in August, Copeland Hanzas announced she wouldn’t comply with the Trump administration’s request, arguing Vermont law “specifically prohibits” the state and municipal governments from sharing voters’ personal details with the federal government for certain uses. That includes, per the law, handing over voters’ information so federal agencies can compare it to “personally identifying information contained in other federal or state databases.”

At that time, a number of other states had received similar requests from the Trump administration for voter information. Some states shared the information, while others, including Maine, declined the request. The federal government has since sued some of those states that declined the demand.

In the lawsuit, attorneys in the voting section of the U.S. Department of Justice’s Civil Rights Division suggested their inquiry is meant to ensure Vermont’s registered voter list is accurate. The federal attorneys requested that a judge order Copeland Hanzas to comply with the request to turn over voter information. 

A spokesperson for the Secretary of State’s Office said on Tuesday that they weren’t familiar with the details of the lawsuit and declined to comment. 

“We have not yet been served with this lawsuit but we look forward to defending Secretary Copeland Hanzas in this case,” Amelia Vath, a spokesperson for the Vermont Attorney General’s Office, which represents Copeland Hanzas in the case, said in a statement. 

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