Proposed legislation being debated now in Utah and Virginia aims to allow optometrists in those states to perform YAG capsulotomies, among other procedures. Photo: Nathan Lighthizer, OD. Click image to enlarge.

Last year, optometry netted some big wins in expanded scope of practice laws. Now, many states are fresh into their new legislative sessions for the 2022 calendar year, with expanded scope laws being molded in Utah, Virginia and other states.

Here’s a breakdown of what’s in the works and what’s at stake for ODs who practice in these areas.

Utah ODs Push to Practice at Their Level of Training

In Utah, the state’s Optometric Practice Act hasn’t been updated for nearly 30 years, says optometrist Weston Barney, president of the Utah Optometric Association (UOA). Dr. Barney and other members of the UOA are currently working on the bill, which he says would allow ODs in their state to practice at the level being taught in optometry schools.

For example, the current scope law prohibits optometrists from performing surgical procedures. Technically, optometrists in Utah do minor surgical procedures based on Medicare definitions, such as foreign body removal which can be as simple as eyelash epilation, Dr. Barney explains.

“Since we are updating the bill, we thought, why not bring it to modern times to include training optometrists receive currently? All 23 optometry schools are teaching laser procedures, so we also want to update the law to where it allows optometrists to practice that full scope, including lasers,” Dr. Barney says.

Regarding the bill’s current status, it should be assigned to a state congressional committee soon, Dr. Barney says. If passed, the bill would ultimately improve patient care, according to its proponents.

Utah, like Wyoming, is a rural state, and many patients who live in these settings often have to drive for hours in order to be seen by an ophthalmologist after an OD referral.

“Many of our patients in rural Utah are having to travel to appointments. The bill would reduce the redundancy of visits,” Dr. Barney suggests.

For example, if a patient living in a rural area is referred for a YAG laser procedure by their local OD, and the referring ophthalmologist is two hours away, these patients are forced to drive for several hours or have a family member take a day off work to get them to the appointment, Dr. Barney explains.

While some ophthalmologists may argue that they do provide care in these rural areas, the counterargument is that their coverage is minimal at best, and usually one day a month in a remote office with long wait times for appointments, Dr. Barney says.

One partner in the UOA is a new optometry school, the Rocky Mountain University of Health Professions College of Optometry, which is slated to open in 2023. In order to attract quality students to the school, the state shouldn’t have scope limitations, Dr. Barney suggests.

Laser Privileges in Play for Virginia ODs

In Virginia, two state bills are in play: House Bill 213 and Senate Bill 375, which would allow optometrists to use lasers for three in-office procedures to treat glaucoma and provide after-cataract surgery care.¹

In an op-ed published in the Bristol Herald Courier, optometrist Amanda Umlandt, president elect of the Virginia Optometric Association, wrote, “There are now eight states where optometrists are able to perform these laser procedures. There are many more programs training optometrists to perform these procedures and excel in their delivery. These procedures are quick, safe and part of every graduating optometrist’s education and experience. Being able to provide this care to my patients isn’t about reimbursement; it’s about access to care and providing the highest level of care to patients, no matter where they live.”²

As of press time, the two bills were going before full congressional committees, according to the Virginia Optometric Association.

Other Updates

Expanded scope bills are also being pursued in West Virginia, Colorado and Washington, according to the state government relations committee of the AOA. Stay tuned as further details become available.