A bill that will expand optometrists’ scope of practice in West Virginia passed in both the House and Senate on March 13. Gov. Joe Manchin signed it into law on April 2.

The final bill gives the West Virginia Board of Optometry more authority in developing the scope of practice for optometrists. “By proposing legislative rules, the board can keep the scope expanding according to the education and training being offered at accredited schools and colleges of optometry,” says West Virginia optometrist B.J. Nibert, who was instrumental in advocating for the legislation.

With the new bill, the drug formulary will be completely under the oversight of the Board of Optometry. “The board will have the authority, without any further oversight of any other body, to determine which drugs and drug delivery systems are applicable to the practice of optometry,” Dr. Nibert adds.

The final bill removes the complete prohibition of surgery by optometrists and includes administering medication by injection. Both of these areas will be addressed by legislative rules promulgated by the board.

Additionally, the specific authority to order lab testing relevant to the treatment and management of ocular diseases is included in the final bill. The purpose was to protect the patients from denial from third-party payers, Dr. Nibert says.

As the bill moved through the legislature, different provisions were added and then deleted, such as allowing optometrists to perform laser surgery (although the board did not include specific lasers or surgical procedures in its legislative initiatives). Still, the final bill is in line with the board’s original intent to set up a more streamlined way to update the rules and regulations for optometrists. “Our goal was to have language that was more inclusive than restrictive. Additional surgeries and lasers can now be addressed through the rule-making process,” Dr. Nibert says.

The bill process was a difficult battle at certain points, as optometrists faced attacks by organized medicine, Dr. Nibert adds.

The last change in West Virginia’s scope of practice was in 1997, when optometrists earned oral prescriptive authority rights.

“Moving forward, West Virginia will be able to continue to expand our scope of practice as the board proposes rules, rather than introducing new legislation for each change,” Dr. Nibert says.