Optometry Scope of Practice in the United States

May 28, 2021
7 min read
67.9k views
The-Scope-of-Practice-Infographic_Featured-Images.png

What is the optometry scope of practice in your state?

As a new graduate optometrist, it is important to know the limitations of the optometry scope of practice in each state.

You spend 4 years of your life dedicated to eye care, 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. You must get involved with your state association and work hard to bring your state’s scope of practice to the next level.

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 2021!

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 2021!

1. Oral medication authority optometry scope of practice

In these states, optometrists cannot prescribe oral medications:

  • New York

Some or all oral medication prescription authority: the other 49 states (except NY).

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
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • 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
  • 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
    • Montana
    • New Mexico
    • North Dakota
    • North Carolina
    • Oklahoma
    • Oregon
    • Tennessee
    • Utah
    • Virginia
    • West Virginia
    • Wisconsin
  • Treat Anaphylaxis only
    • Alabama
    • Arizona
    • Colorado
    • Connecticut
    • Delaware
    • Florida
    • Hawaii
    • Maryland
    • Maine
    • Minnesota
    • Mississippi
    • Nebraska
    • New Hampshire
    • New Jersey
    • Ohio
    • 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
  • 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

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 2021?

Several states are making significant headway with their own scope of practice acts in this 2021 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. To date, the following states have seen recent legislative progress.

Massachusetts:

Up until 2021, Massachusetts was the only state in the US to deny optometrists authority for treating glaucoma at any level due to significant push-back from other organized medical groups. Finally, after years of advocacy, on January 1, 2021, Governor Charlie Baker signed a new multifaceted, telehealth reform bill that will allow optometrists to treat glaucoma with topical medication. The law will come into effect 90 days after the governor’s signature. Below are the specific changes made to the scope of practice:

Bill S. 2984 includes:

  • Use and prescription of topical and oral therapeutical agents, including those in schedules III, IV, V, and VI, for diagnosing, preventing, treating or managing glaucoma.
  • Ability to prescribe all necessary eye medications, including oral anti-infectives.

Pennsylvania:

Doctors of optometry in Pennsylvania have been working for almost two decades to expand their legislative scope of practice. On October 29, Governor Tom Wolf signed Act 99 (House Bill 2561) which provides an amendment to the state’s Optometric Practice and Licensure Act. Not only does the amendment expand the ability optometrists to examine, diagnose and treat patients, but also gives the state board of optometry sole authority to set optometric formulary.

Act 99 Bill Includes:

  • Optometrists can now use any and all means or methods for the examination diagnosis and treatment of all conditions of the human visual system.
  • Practitioners can now treat ALL forms of glaucoma, including narrow-angle glaucoma.
  • Practitioners now can treatment of dry eye and allergies without the need to consult with a licensed physician after six weeks of continuous treatment.
  • Their ability to prescribe codeine, hydrocodone, and other combinations has been restored.
  • They can administer epinephrine auto-injectors for the treatment of anaphylaxis. The Pennsylvania Board of Optometry has been given the exclusive right to manage and determine optometric formulary.

Iowa:

After four years of hard work, Iowa’s new bill HF310 was approved on June 29, 2020, which now allows optometrists with the proper training and board approval to administer injections to treat certain ocular or ocular-related conditions. Going forward, optometrists who wish to implement these treatment modalities must have sufficient education and clinical training.

Bill HF 310 includes:

  • Subconjunctival injection for medical treatment of the eye
  • Intralesional injections for chalazia
  • Botulinum toxin into the muscles of facial expression innervated by the facial nerve, including for cosmetic purposes
  • Injections to counteract anaphylactic reactions

Wyoming:

On April 2, 2021, Gov. Mark Gordon signed the law which amends the state’s optometric scope of practice for certain laser and surgical procedures. In Wyoming’s 17 out of 23 counties have fewer than six people per square mile, greatly limiting residents’ access to healthcare. This new bill will allow better patient care and reduce delays in treatment as the patient can be acutely treated and no further referral is required.

Wyoming H.B. 39 new surgical procedures include:

  • YAG laser capsulotomy
  • Selective laser trabeculoplasty
  • Laser iridotomy
  • Lesion removal

In the Pipeline:

Mississippi:

As of March 9, 2021, optometrists are still waiting for the new bill H.B 1302 to be approved by Gov. Reeves and the state board. This bill will expand optometrists’ ability to remove and excise lesions as well as grant doctors injectable authority. It will also improve pharmaceutical authority.

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

New York:

New York is the last state where doctors of optometry are unable to prescribe oral anti-infectives. Each year prior to 2020, the NYSOA has unsuccessfully tried to pass a bill that would grant them authority to use certain oral medications to treat eye conditions in patients. However, as of March 4, 2021, the senate has finally passed the orals bill. The bill is still waiting to be reviewed and approved by the Assembly, but optometrists are very hopeful it will finally pass this year.

Bill S 1519 includes:

  • Authorize optometrist to prescribe a formulary of oral therapeutic pharmaceutical agents for the treatment of eye diseases

Florida:

As of March 2021, the House Professions and Public Health Subcommittee have advanced bill HB 631 that would allow optometrists to perform certain eye surgeries and prescribe an expanded list of medications. The bill is now moving to House Health & Human Services Committee.

Bill HB 631 includes:

  • Optometrists would be allowed to use lasers to perform surgeries but may not perform an ophthalmic procedure or therapy that requires drug-induced alteration of consciousness or that burns, cuts or incises the globe of the eye.
  • Increase prescription rights of opioids and pain killers without the consultation of a physician

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.

covalentcareers
About Quy Nguyen, O.D.

Quy Nguyen grew up in the Bay Area in California and attended the University of California at Berkeley where he received a Bachelors in Integrative Biology. He obtained his Doctor of Optometry from the SUNY State College of Optometry in …

About Laura Goldberg, OD/MS

I am currently an associate optometrist at Woolf Eye Lab in Pasadena, MD. I completed a residency in Primary Care & Ocular Disease at VAMC Wilmington, DE. Graduated from New England College of Optometry, Class of 2016. For my MS …

About Matt Geller, OD

Matt Geller, OD is the co-founder and CEO of CovalentCreative - an independently owned, eyecare professional-only, digital marketing agency that provides content, creative, and technology services for forward-thinking eyecare organizations. CovalentCreative is the parent company of EyesOnEyecare.com - a digital …

Share
Latest
Jobs
Free CE
Eyes On Eyecare:
CovalentCreative:
Optometry:
Ophthalmology:
© 2021 Eyes On Eyecare. All rights reserved.
Privacy Policy Terms of Service