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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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19 Vermont school budgets fail as education leaders debate need for reform

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19 Vermont school budgets fail as education leaders debate need for reform


MONTPELIER, Vt. (WCAX) – Most Vermont school budgets passed Tuesday, but 19 districts and supervisory unions saw their spending plans rejected — an uptick from the nine that failed in 2025, though well below the 29 that failed in 2024.

Some education leaders say the results show communities are largely supportive of their schools.

“We’re starting to kind of equalize out again towards the normal trend of passage of school budgets each year,” said Chelsea Meyers of the Vermont Superintendents Association.

Sue Ceglowski of the Vermont School Boards Association said the results send a clear message. “Vermont taxpayers support Vermont’s public schools,” she said.

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Meyers said the results also raise questions about the scope of education reform being considered in Montpelier. “If we are going to reform the system, it might not require sweeping broad changes as are being considered right now, but a more concise approach to consider that inequity,” she said.

But in districts where budgets failed, officials say structural changes are still needed. In Barre, where the budget failed, Barre Unified Union School District Board Chair Michael Boutin said the Legislature must, at a minimum, create a new funding formula. “We have to have that in order to avoid the huge increases and decreases — the huge increases that we’ve seen in the last couple years,” Boutin said.

He said the rise in school budgets is separate from why property owners are seeing sharp tax increases. The average state increase in school budgets is 4%, but the average property tax increase is 10%, driven by cost factors including health care. “There’s a complete disconnect, and that’s a product of the terrible system that we have in Vermont with our funding formula,” Boutin said.

Ceglowski says the state should address health care costs before moving forward with rapid education policy changes. “Addressing the rapid rise in the cost of school employees’ health benefits by ensuring a fair and balanced statewide bargaining process for those benefits,” she said.

The 19 districts that did not pass their budgets will need to draft new spending plans to present to voters, which often requires cuts. Twelve school districts are scheduled to vote at a later date.

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6 of the Quirkiest Towns in Vermont

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6 of the Quirkiest Towns in Vermont


Vermont is, for many visitors, the postcard-perfect New England state. A part of the United States since 1791, the first to join the Union after the Thirteen Original Colonies, Vermont has many unique, and sometimes quirky, features. The place has attracted artists and other creative geniuses, some of them decidedly eccentric, from its earliest days. The natural parts of Vermont, like the famous Lake Champlain, offer unusual points of interest for visitors and locals alike. With a state as rich in traveling attractions, it should be little wonder that some of them come with a quirk or two.

Montpelier

Summer Farmers Market in Montpelier, Vermont. Editorial credit: Phill Truckle / Shutterstock.com

Montpelier, while being Vermont’s charming capital, is the tiniest among all US state capitals with just around 8,000 residents. For comparison, the second-smallest, Pierre in South Dakota, has a population of about 14,000. Established in 1787, this historic town warmly welcomes visitors with a variety of landmarks, including the Vermont History Museum and the sprawling 200-acre Hubbard Park. The State House is also open to the public for tours. Just a short drive west, less than an hour away, lies Lake Champlain, one of the Northeast’s most beloved watersides.

The town’s name pays homage to Montpellier, a beautiful city in southern France. This naming reflected the high regard for France at the time, especially for their support during the US War of Independence. Interestingly, Montpelier has experienced its share of flooding, with significant damage occurring in the years 1927, 1992, and most recently in 2023.

Elmore

Lake Elmore State Part with beautiful autumn foliage and water reflections at Elmore, Vermont
Lake Elmore State Part with beautiful autumn foliage and water reflections at Elmore, Vermont

Elmore, a charming small town in Lamoille County with fewer than 900 residents, is a favorite spot for autumn leaf-peepers. Located north of Montpelier, this peaceful town has its own unique charm, including several local landmarks sharing the name ‘Elmore,’ which adds to its character. It’s important to note that Elmore town is separate from East Elmore. To the west, Elmore Mountain overlooks the area, while Elmore State Park lies just north of the town itself. Enjoying waterside beauty, Elmore Lake is often listed among Vermont’s most picturesque lakes, with its waters flowing into the Lamoille River through Elmore Pond Brook. Like Montpelier, Elmore is situated east of Lake Champlain. For those seeking a more bustling scene or a change of pace, the vibrant city of Burlington, just an hour’s drive west, makes for a perfect day trip or weekend getaway.

Stowe

Aerial view of Stowe Vermont and autumn colors.
Aerial view of Stowe Vermont and autumn colors.

Stowe, with a lively population of 5,300, is Vermont’s top spot for adrenaline seekers and the eccentrics among us, earning its reputation as the state’s premier ski and snowboard destination. The Stowe Mountain Resort proudly calls itself the “ski capital of the east”—that’s the eastern United States. Nestled near the breathtaking Mount Mansfield, Stowe offers more than just winter fun; warmer months bring plenty of activities like hiking and mountain biking in the beautiful Cady Hill Forest.

The town also has a rich history, being the home of Jake Burton Carpenter (1954-2019), the visionary behind Burton Snowboards and a trailblazer in making snowboarding an international sport. While some might have called him eccentric when he launched his company in 1977, today he’s celebrated as a true pioneer whose legacy keeps inspiring young snow sports enthusiasts, like those at Mount Mansfield Winter Academy, a special school dedicated to nurturing the next generation of champions.

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Manchester

View of the historic and colorful Manchester Village in Manchester, Vermont with tulips in bloom
View of the historic and colorful Manchester Village in Manchester, Vermont with tulips in bloom

Manchester, a town with 4,500 residents located in southwest Vermont, is popular among art and architecture enthusiasts. It features Hildene, the estate of Abraham Lincoln’s son Robert, which boasts an impressive Georgian Revival house and grounds. The town’s American Museum of Fly Fishing showcases numerous rods, flies, and related gear, attracting many superstitious anglers. Manchester is also home to Orvis, a renowned fishing and clothing company. The Southern Vermont Arts Center hosts exhibitions, and includes a sculpture garden and performance space. Nature lovers should visit Mount Equinox, west of town, or explore the Green Mountain National Forest to the south.

Eccentric fact: Jonathan Goldsmith, known for portraying “The World’s Most Interesting Man” in Dos Equis commercials, resides in Manchester. Stay quirky, my friends.

Brattleboro

Historic downtown of Brattleboro, Vermont.
Historic downtown of Brattleboro, Vermont. Image credit jenlo8 via Shutterstock

Brattleboro, with a population of 12,100, sits along the Connecticut River and features a variety of attractions and oddities. Located just west of New Hampshire—in which the Connecticut River forms the border—and just north of Massachusetts, the town is an ideal midpoint for exploring the wider New England region. Outdoor enthusiasts will appreciate Fort Dummer State Park, welcoming hikers, bikers, and campers alike. Among the more renowned eccentric figures in history, British writer Rudyard Kipling moved to Brattleboro after marrying a Vermont woman in 1892. Their home, Naulakha, references his birth and childhood in India. Kipling believed that Brattleboro’s conservative small-town culture created an

Woodstock

Snowy day at the farm in Woodstock.
Snowy day at the farm in Woodstock. Editorial credit: James Kirkikis / Shutterstock.com

Woodstock, a town with 3,000 residents located in upstate New York, is separate from the famous 1969 cultural event. This southeastern town attracts architecture enthusiasts, particularly for the First Congregational Church, built in 1807 and featuring a bell cast by American revolutionary Paul Revere, and the Norman Williams Public Library, completed in 1884. For outdoor activities, visitors can walk in Woodstock Town Forest, located south of the town, or enjoy panoramic views from the Marsh Billings Rockefeller National Historical Park, the only part of the US National Park system in Vermont besides the Appalachian Trail. Recently, Woodstock has modernized its infrastructure with digital technology, launching the “Wireless Woodstock” initiative in 2011, which provides free Wi-Fi across the entire town. It’s not quirky; it’s just cool.

Vermont’s Quirky Small Towns May Also Be Its Best

These small Vermont towns show the state’s sometimes quirky, but never boring character. Architecture fans will find unusual, beautiful examples state-wide. Montpelier is an oddly pint-sized capital with heavyweight history. Brattleboro has long attracted strange, sometimes brilliant types, whether foreign or domestic. Manchester is interesting enough for the World’s Most Interesting Man. And with abundant natural parks, the Green Mountains, and the majesty of Lake Elmore and Lake Champlain, the quirks of Vermont’s best features should attract even the most straight-laced visitors.



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Vermont postal worker allegedly threw away mail she was supposed to deliver for months

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Vermont postal worker allegedly threw away mail she was supposed to deliver for months


Crime

During a search of a dumpster where the worker allegedly discarded the mail, police found several packages and holiday cards.

A Vermont postal worker was cited and suspended for allegedly throwing away mail that was supposed to be delivered to other people, according to police.

Natasha Morisseau, 34, of North Troy, was cited on nine counts of petty larceny and five counts of unlawful mischief, Vermont State Police said in a statement. She works as a mail carrier for the town’s United States Postal Service (USPS) office.

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Officers were first alerted to the discarded mail on the afternoon of Jan. 23, according to police. Upon finding the mail in a dumpster on Elm Street in North Troy, they determined that none of it was for that address.

Police identified Morisseau as a person of interest and learned that she was a postal employee. They confirmed that she had regularly been throwing away a small amount of mail under her care since at least October 2025, according to the statement.

After searching the dumpster and Morisseau’s mail vehicle, officers found opened and unopened packages, along with several holiday cards, one of which contained money. Morisseau was later cited Feb. 14 and is due to appear March 17 in Vermont Superior Court, police said.

Since Jan. 23, Morisseau has been suspended by USPS, and all recovered mail has been given back to them for delivery, according to the statement. The case has been forwarded to the USPS’ Inspector General for further review.

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