As a new graduate optometrist, it is important to understand the level of scope of practice in each individual state.
You spend 4 years of your life dedicated to eyecare, so why not practice to the fullest extent? Many new graduates will realize that their state does not allow them to practice full-scope optometry. Therefore, it is important to get involved with your state association and help continue to fight for expansion in scope of practice.
What is the optometry scope of practice in your state?
To communicate this, Quy Nguyen, OD, and Matt Geller, OD, developed an infographic showing the optometry scope of practice in each state, to easily compare the scope in each state and the progress optometry has made!
We've updated the scope of practice infographic for 2022!
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What's the scope of practice in your state?
Download the full infographic to visualize the scope of practice in your state!
Keep reading to learn more about the scope of practice in your state, or scroll to the end to learn from Laura Goldberg, OD what's new for 2022!
1. Oral medication authority optometry scope of practice
As of October 2021, optometrists in all states now have oral medication authority!
2. Glaucoma treatment optometry scope of practice
As of 2021, optometrists can treat glaucoma topically in all states!
3. Oral steroid prescription authority optometry scope of practice
In these states, optometrists cannot prescribe oral steroids:
- Florida
- Maine
- Michigan
- Minnesota
- New York
- South Carolina
- Washington
- Washington, D.C.
In these states, optometrists can prescribe oral steroids:
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- Georgia
- Hawaii
- Idaho
- Indiana
- Illinois
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maryland
- Massachusetts
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- West Virginia
- Wisconsin
- Wyoming
4. Injectables authority optometry scope of practice
In these states, optometrists can provide injectables to:
Treat anaphylaxis and other needs
- Alaska
- Arkansas
- California
- Georgia
- Idaho
- Indiana
- Iowa
- Kentucky
- Louisiana
- Mississippi
- Montana
- New Mexico
- North Carolina
- North Dakota
- Oklahoma
- Oregon
- Tennessee
- Utah
- Virginia
- West Virginia
- Wisconsin
- Wyoming
Treat anaphylaxis only
- Alabama
- Arizona
- Colorado
- Connecticut
- Delaware
- Florida
- Hawaii
- Illinois
- Maryland
- Maine
- Minnesota
- Mississippi
- Nebraska
- New Hampshire
- New Jersey
- Ohio
- Pennsylvania
- Texas
- Vermont
- Washington
- Washington, D.C.
5. Lasers Authority (LPI, SLT, ALT, YAG Capsulotomy) optometry scope of practice
In these states, optometrists can use lasers to treat ocular conditions:
- Alaska – YAG Capsulotomy / ALT / SLT / LPI / PRK
- Arkansas – YAG Capsulotomy / ALT / SLT
- Colorado - YAG Capsulotomy/ ALT / SLT / LPI
- Indiana — YAG Capsulotomy / ALT / SLT / LPI
- Kentucky – YAG Capsulotomy / ALT / SLT / LPI
- Louisiana – YAG Capsulotomy/ ALT / SLT / LPI
- Mississippi — YAG Capsulotomy
- Oklahoma – YAG Capsulotomy / ALT / SLT / LPI / PRK
- Wyoming – YAG Capsulotomy / ALT / SLT / LPI
- Virginia – YAG Capsulotomy/ALT/SLT/LPI
This list is a work in progress and we will continue to update this as new changes are made in our ever-so-dynamic profession. See a mistake? Let us know, and we will update it.
We are always working with state associations to keep this as up-to-date as possible! Thank you!
What’s the scoop on scope changes for 2022?
Several states are making significant headway with their own scope of practice acts in this 2022 legislative session. Considering the adversity that the profession faced throughout the ongoing COVID-19 public health emergency, these actions are highly commendable and greatly needed. Since our last update in 2021, the following states have seen recent legislative progress.
Virginia
On March 9, 2022, Gov. Glenn Youngkin signed into law a bill that authorizes optometrists, certified by the state board, to perform laser procedures. Virginia is the ninth state to expand their scope of practice to include these procedures. Their strongest stance when trying to pass the bill was that out of over 100,000 laser procedures that have been performed by optometrists in other states, there has not been one filed complaint.
The state requires doctors of optometry to become certified through an accredited college of optometry, including hands-on training, before performing the laser procedures.
Virginia bill HB 213 includes the following laser procedures:
- YAG laser capsulotomy
- Selective laser trabeculoplasty
- Laser peripheral iridotomy
Mississippi
As of March 10, 2022, bill H.B 1302 was approved by Gov. Reeves and the state board after great opposition. This bill will expand optometrists’ ability to remove and excise lesions as well as grant doctors’ injectable authority. It will also improve pharmaceutical authority. Optometrists will have to be credentialed for these new procedures/ prescribing authority including at least 32 hours of coursework, a written and clinical skills assessment and at least 8 hours of preceptorship with an ophthalmologist or optometrists licensed to preformed these procedures.
Bill H.B. 1302 includes:
- New injectable authority; excision and removal of non-cancerous lid lesions, as well as chalazion
- Oral therapy: schedules 2-5 and oral steroids
- Authority to perform YAG laser capsulotomy
Colorado:
Governor Jared Polis recently signed H.B. 22-1233 into law. As of June 7, optometrists can provide expanded services, including certain office-based optometric surgical procedures for glaucoma and cataract patients.
HB22-1233 includes the following:
- Continue the board and regulation of optometry for 11 years until September 2033
- Expand the definition of the practice of optometry to include any service, procedure, or treatment that falls within the training and skills of the state’s optometrists. This will include injections (excluding intraocular injections penetrating the globe), removal and biopsy of qualifying eyelid lesions; chalazion incision and curettage; repair of qualifying eyelid lacerations; and corneal cross-linking as well as laser capsulotomy, laser peripheral iridotomy, and laser trabeculoplasty.
In the pipeline:
Utah
As of February 2022, legislation to expand the optometric scope of practice in Utah passed the House with a 48-23 vote. This bill would allow optometrists to perform YAG, SLT and LPI procedures. The bill is now moving on to the Senate, however, the bill is facing strong opposition from local ophthalmology and medical associations.
Bill HB224 laser procedures would include:
- YAG laser capsulotomy
- Selective laser trabeculoplasty
- Laser peripheral iridotomy
How to obtain laser certification as an optometrist
The number of states that are allowing optometrists to practice laser and injectable procedures is rapidly growing. As of now, nine states can perform certain laser procedures while twenty-two states can use injections for small procedures such as lesion removals. However, in order to be able to practice these procedures in office, optometrists are required to complete a board certification course and pass a written exam.
Once the written section is passed, optometrists are required to pass a practical examination. Some states even require that an optometrist shadow an ophthalmologist for a certain number of days and perform the procedures under their watch before they are allowed to practice on their own.
In order to prepare for further scope changes in the future, many optometry schools now offer training in laser and injection procedures. AOA’s optometry meeting is also offering live training courses.
Get involved with your state’s optometric association
Are you looking to help expand your state’s scope of practice? The AOA is dedicated to ensuring doctors of optometry can practice to the highest level of medical eye care. They are always looking for new optometrists to help advocate and fight for the expansion of the scope of practice and even maintain our current laws. It can be overwhelming for optometrists to navigate the legislative system and many don’t know where to begin. The first step is to join your local state optometric organization to learn how you can get involved.
The AOA has created an advocacy toolkit that helps optometrists understand the process of advocating for legislation and ins and outs of political advocacy.
