Utah is the latest US state to submit a bill to allow optometrists to perform procedures including laser capsulotomy, laser trabeculoplasty and laser peripheral iridotomy. If it passes, Utah will become the ninth US state to extend optometrists’ scope of practice to include laser, joining Alaska, Arkansas, Indiana, Kentucky, Louisiana and Oklahoma, plus Wyoming and Mississippi, which both passed similar bills in 2021.
As part of the Utah bill’s public submissions, Salt Lake City ophthalmologist Dr Jared Parker argued, “There is no such thing as routine eye surgery. Eye lasers cut tissue and carry significant risk.” No training optometrists have received “comes close” to that of an ophthalmologist’s, he told local online TV channel KSL.com. In the same KSL report, Weston Barney, president of the Utah Optometrics Association, said, "Our goal is not to enter operating rooms that provide major surgical care for patients, but to provide these minor, in-office treatments that can save patients time and money.”
Mississippi optometrists have injectable authority, can perform laser capsulotomy and excise chalazion and noncancerous growths in and around the eyelid. To do so, they are required to complete training and assessment, including at least 32 hours of coursework, a written examination and clinical skills assessment, plus at least eight hours of preceptorship with an ophthalmologist or optometrist licensed to perform these procedures, said optometrist Dr Ryan Wally.
In the UK, nurses began YAG capsulotomy training in 1997, while Don Williams became the UK’s first optometrist to successfully complete the Royal College of Ophthalmologists-accredited Birmingham Laser Simulation Course for YAG CAP, PI, SLT, retinal laser, argon laser and Navilas laser in 2019. Since then, specially trained optometrist- or nurse-run YAG laser clinics have become the norm at most large ophthalmic training hospitals in the UK.
New Zealand joined the movement with a 2021 joint ophthalmology-Optometrists and Dispensing Opticians Board pilot study to test the parameters and protocols for training to allow a hospital-based optometrist to provide YAG laser procedures in a safe and effective manner*. “From the feedback, this is a really robust, safe and well-structured process, so I feel quite positive that this will be successful in implementation,” said the then ODOB chair Jayesh Chouhan at the time. The ODOB is still to report back about the outcome of the public consultation, which closed at the end of 2021.
