Following successful passage of the Better Access to Quality Eye Care bill (SB 110) in Kentucky on February 24 (see “ Kentucky Expands O.D.’s Scope of Practice,” March), lawmakers in Nebraska, Texas and South Carolina are also considering new legislation that would permit optometrists to perform several surgical procedures as well as administer pharmaceutical injections into the eyelid.

Here is an overview of what’s on the table:

• Nebraska. Legislative Bill 316, which was first proposed on January 12, would allow optometrists to perform YAG laser capsulotomies, laser peripheral iridotomies and laser trabeculoplasties. In addition to these laser procedures, Nebraskan O.D.s would be allowed to perform minor surgical procedures to remove skin lesions from the eyelids and ocular adnexa, and facilitate drainage of cysts and glands of the eyelid, conjunctiva or ocular adnexa. Finally, O.D.s would be able to inject pharmaceutical agents into the eyelid for the treatment of cysts or swollen glands.
Texas. Senate Bill 1056, which was first proposed on March 23, would allow optometrists to perform YAG laser capsulotomies as well as any type of all-laser glaucoma surgery. Texan O.D.s would also be permitted to surgically remove any superficial foreign body in the conjunctiva, eyelid or corneal epithelium that has not perforated Bowman’s membrane. Additionally, they would be allowed to remove loose epithelium to facilitate corneal healing, drain any abscess or cyst on the eyelid or conjunctiva, use tissue glue to close a wound, and close the puncta via cauterization. Finally, O.D.s would be permitted to inject pharmaceutical agents into the eyelid for the treatment of cysts or swollen glands.
• South Carolina. Senate Bill 503, which was first proposed on February 3, would permit optometrists to inject pharmaceutical agents into the eyelid for the treatment of cysts or swollen glands.

Proposed Optometry Bills
Nebraska Legislative Bill No. 316 to change provisions relating to the practice of optometry.
Texas Senate Bill No. 1056 relating to regulation of the practice of therapeutic optometry.
South Carolina Senate Bill No. 503 relating to prescribing and administering pharmaceutical agents by an optometrist.
Further, the bills in Nebraska and Texas would authorize faculty at optometry schools in those states to perform and teach the aforementioned surgical procedures.

This comes as welcome news to Joe E. Ellis, O.D., president of the American Optometric Association, who has long advocated that optometrists be granted an expanded scope of practice.

“On the heels of this important win in Kentucky, we must commit to redoubling our efforts,” Dr. Ellis said in a March 2 statement. “Now is the time for optometry to build upon this most recent victory and fight to ensure that our message is heard loud and clear in the nation’s capital and in statehouses across the country: O.D.s have the training and education to provide much needed treatment now; but outdated laws and discriminatory practices are holding back greater patient access to quality optometric care.”

These proposals are currently being reviewed by legislative committees in each state.