The state of Texas is big. But is it big enough to sustain two optometry schools? The University of the Incarnate Word (UIW) thinks so.

Located in San Antonio, UIW plans to open a new school of optometry as early as autumn 2009, with a proposed entering class size of 60 students, says university Provost Terry Dicianna, Ph.D. The university is hunting for new land on which to build the school (its main campus has no room for an optometry school), and it is advertising for a dean.

However, the University of Houston College of Optometry, a well-established public optometry school, is only some 200 miles away. Is another school of optometry needed so near by?

Texas is growing. San Antonio is growing, Dr. Dicianna says. Health-care needs are growing nationally, regionally and locally.

There are currently only 17 optometry schools in the United States. The population of the Untied States is growing substantially, but there hasnt been any increase in the number of [O.D. school] graduates in about 15 or 16 years, he says. That number has stayed stablearound 1,250 to 1,280 in the nation per year. So, we see a need.

However, optometrists do not see a need, Dr. Dicianna says. Ive heard it over and over again, but the data do not support what the individuals are saying.

Mario Gutierrez, O.D., is one of those individuals. His private practice is just a few blocks from the UIW main campus, and hes been in close contact with Dr. Dicianna and other school officials as plans for the new school have developed. Indeed, more than a year ago, UIW administrators invited Dr. Gutierrez and other local optometrists to voice their thoughts about the proposed optometry school.

The subject of another optometry school makes the hair on the back of most O.D.s necks go straight up, Dr. Gutierrez says. I dont see that theres a huge need for more optometrists. And, if we needed more O.D.s, then Im sure the University of Houston would open up to more students.

His chief concern: Im not convinced that a small private school [so close to a larger public optometry school] is going to be able to produce top-notch optometrists. The University of Houston already takes the cream of the crop from the applicant pool.

At least one Texas optometrist sees it differently. Unlike most O.D.s in Texas, I welcome UIWs school of optometry, says Ricky Alaniz, O.D., who has a busy private practice in rural Carrizo Springs, not far from the Mexico border. Contrary to popular belief, there are not too many O.D.s in Texas. We have 105 counties in Texas without an optometrist or ophthalmologist. Without more help in rural areas, by 2020, we as a state will not have the manpower to provide high quality health care for our aging population.

A stumbling block to health care in rural Texas is the language barrier. Not enough O.D.s speak Spanish to fix this problem, Dr. Alaniz says. To that end, UIW expects to offer a bilingual certificate in Spanish for its graduates.

In the meantime, UIWs plans are moving forward. The university is close to deciding on a location for its eye clinic. It will be in a low-income, high minority area of town and very close to the university, Dr. Dicianna says.

UIW, which also recently opened a school of pharmacy, is now seeking funding for the new optometry schoolbut not from a corporate sponsor. Dr. Dicianna lays this rumor to rest: The misconception by some of our local optometrists is that we have gotten into bed with a big box store. Were not even talking to a big box store about such an agreement. We have no dollars coming from that source at all.

While the UIW is a Roman Catholic institution and the proposed optometry school will be the only faith-based program in the United States, there will be no religious requirement for the professional degree. However, the evidence-based curriculum will reflect the universitys mission by emphasizing medical ethics and morality, Dr. Dicianna says.

The Texas Optometric Association (TOA) cant stop the university, it says, but it wants to be heard. After seriously studying the matter, the TOA determined that this is a private university whose decision-making process on whether or not to open a new school is beyond our influence, says TOA president, David Wright, O.D. While our members may disagree about whether a new school should be built, everyone agrees that if there is going to be a new optometry school in Texas, it should be first class and should prepare new graduates to practice independent, full-scope optometry anywhere in the country. That is why the TOA has asked for a seat at the table as the planning starts moving forward.

I really wish they werent doing it, Dr. Gutierrez adds. But, I told the administrators, If you do it, just do it right. We dont want to take the profession back to the jewelry store.