The procedures optometrists can and can’t perform are heavily dictated by state legislatures. Most states bar them from many surgeries, but there are several that do allow optometrists to perform minor procedures and laser treatments.

Do optometrists perform surgery?

So, as an optometrist can you perform surgeries? It depends on where you live.

Just a handful of states allow optometrists to conduct laser treatments. And several more authorize optometrists to perform minor procedures such as ocular abnormality corrections. Most other ocular surgical procedures remain primarily within ophthalmologists’ scope of practice.

What states allow optometrists to do laser treatments?

As of 2020, there are five states that do or will provide optometrists the authority to perform certain laser treatments: Alaska, Arkansas, Kentucky, Louisiana and Oklahoma. The exact scope of practice varies in some states, though. Optometrists may be required to attain certification in order to perform certain procedures in their states.

Alaska

Optometrists in Alaska within the last several years enjoyed an expansion of their scope of practice. Authorized laser treatments include:

• YAG Capsulotomy
• ALT
• SLT
• LPI

Arkansas

In 2019, HB1251 was signed into law, expanding Arkansas optometrists’ scope of practice to include certain laser procedures:

• YAG Capsulotomy
• ALT
• SLT
• LPI

Kentucky

Kentucky, in 2011, was the second state to allow properly credentialed optometrists to expand their practice scope to certain laser treatments. Kentucky optometrists are authorized to perform:

• YAG Capsulotomy
• ALT
• SLT
• LPI

Louisiana

In 2014, a third state expanded optometrists’ scope of practice when HB 1065 was signed into law in Louisiana. Optometrists there are authorized to offer:

• YAG Capsulotomy
• ALT
• SLT
• LPI

Oklahoma

Oklahoma has allowed optometrists to perform certain laser treatments for over a decade. Optometrists there are authorized to perform:

• YAG Capsulotomy
• PRK
• ALT
• SLT 
• LPI

Are other states considering letting optometrists perform laser treatments?

Efforts continue moving forward in other states to expand optometrists’ scope of practice. However, it’s not always easy or successful.

In February 2020, the Idaho House of Representatives passed legislation that would extend optometrists’ scope of practice to include certain laser treatments. However, the bill was held up in the state Senate. Similar efforts in Wyoming and Texas have also run aground in recent years.

In various states there’s ongoing discourse about whether and how optometrists’ scope of practice can be expanded to include laser treatments.

States where optometrists can perform minor surgery 

Some states authorize optometrists to perform minor surgeries such as correcting ocular abnormalities. There’s some overlap with states that allow optometrists to offer laser treatments. However, there are also states that include minor procedures but not laser treatments in optometrists’ scope of practice.

Alaska

In addition to laser treatments, Alaska allows optometrists to perform procedures in order to correct ocular abnormalities such as “lumps and bumps.”

Idaho

Idaho optometrists are authorized to perform certain surgical procedures.

Kentucky

Kentucky also allows optometrists to perform both laser treatments and minor surgical procedures to correct ocular abnormalities such as “lumps and bumps.”

Louisiana

Beyond laser treatments, Louisiana optometrists’ scope of practice also includes minor surgical procedures such as chalazion removals.

New Mexico

New Mexico optometrists are authorized to remove ocular abnormalities around the eye including scalpel usage, suturing and injectable local anesthetic usage.

Oklahoma

Oklahoma is another state that authorizes optometrists to perform both laser treatments and ocular abnormality corrections such as “lump and bump” removals.

Oregon

Oregon authorizes optometrists to perform minor surgical procedures that use a mechanical tool to remove or alter human tissue. As long as no suturing is required, this may include, but isn’t limited too, chalazia removal, and eyelid cyst or conjunctival cyst lacing procedures. Additionally, their scope of practice includes scraping, debridement and removal of corneal epithelium.

Tennessee

In Tennessee, optometrists’ scope of practice authorizes them to remove foreign bodies from the ocular region. In addition, they can perform scraping, debridement and removal of corneal epithelium.

Virginia

Virginia optometrists are authorized to perform minor surgical procedures to correct ocular abnormalities such as “lumps and bumps.”

Scope of practice is evolving everywhere

There are ongoing efforts to expand optometrists’ scope of practice to include minor surgical procedures and laser treatments.

It’s important to keep track of ongoing discussion and any potential legislation in your state to ensure you’re aware of upcoming changes. As optometrists continue to prove their ability to perform procedures authorized by their local scope of practice there will be more conversation regarding scope expansion.