Optometrists Ready for Eye Surgery, State Laws Lag

Many patients nationwide, particularly in rural areas, face significant challenges accessing essential healthcare, with eye care experiencing a severe shortage of ophthalmologists. A large, skilled workforce of optometrists is currently unable to perform routine and medically necessary procedures due to restrictive state laws.

More than a dozen states allow optometrists to perform YAG laser capsulotomies, a safe in-office procedure for secondary cataracts. However, most states restrict this to ophthalmologists, despite optometrists' extensive doctoral training and the procedure's excellent safety record, as evidenced by studies showing extremely low negative outcomes.

Expanding optometrists' scope of practice is associated with increased utilization of YAG procedures. Medicare data indicates a substantial rise in these procedures in states that have expanded optometrist rights, with greater benefits observed in non-metropolitan areas, suggesting isolated patients may benefit most.

Similar reforms expanding practice rights for nurse practitioners and physician assistants have yielded positive results, improving access and reducing costs. Policymakers face opposition from ophthalmology groups, but prioritizing patient needs over professional turf battles is crucial. Given the aging population and deepening ophthalmologist shortage, allowing optometrists to practice to the full extent of their training is an effective step to improve patient access to eye care.