This week, Iowa optometrists joined the growing number of practitioners allowed to treat certain ocular conditions with injections. Iowa’s bill (HF 310), approved on June 29, now clarifies that ODs with the proper training and board approval can administer subconjunctival injections to treat ocular conditions, intralesional injections to treat chalazia, botulinum toxin (including for cosmetic purposes) and injections to counteract an anaphylactic reaction.1

“This is the culmination of several years of work—four years of legislative battles, but five years of work,” says Brian Kirschling, OD, president of the Iowa Optometric Association. “We are very pleased to get it to the Governor’s desk and get it signed.”

Already through the house, the bill passed in the senate at the beginning of March on a 41 to 8 vote, he explains. Then COVID hit and everything shut down. The bill had some language changes that required another round in the house and on June 3rd, the house passed the bill on a 91 to 6 vote.

“We are very pleased to get that kind of support among our state legislators,” Dr.  Kirschling says. “There is an ophthalmologist serving in the Iowa senate, which has been a roadblock in the last couple of years, but we are happy to still have a 41-8 support in the senate despite that.”

Part of the success is due to exceptional leadership, according to Dr. Kirschling. The Association’s executive director, Gary Ellis, has been at the helm for 25 years.

“It is very helpful to have longevity when it comes to our optometric association’s front office,” he says. “Those relationships built at the state capital with legislators don’t happen overnight. Gary and his crew deserve a lot of the accolades, along with our docs who sat in and fought the subcommittee and committee battles.”

Training Opportunities

The bill also specifies that those looking to implement these treatment modalities must have sufficient education and clinical training, whether from an accredited college or university or equivalent education provider. The Iowa Optometric Association has already been offering workshops to ODs for several years in preparation for the expanded scope.

“Going forward, we will continue to offer that on an expanded basis for our ODs who don’t have that skillset; our younger ODs graduating from optometry school already have that training and skillset under their belt,” Dr. Kirschling explains. “For docs who wish to learn those skills, the opportunities are available to them.”

 The expanded scope will vastly expand patient care in rural states like Iowa, Dr. Kirschling adds. “Optometrists practice in nearly all of Iowa’s 99 counties and, traditionally, that has allowed Iowa optometrists to be front-line providers of full-scope eye care.”

1. Iowa Legislature. House File 310, an Act relating to the practice of optometry. Accessed July 1, 2020.