A public hearing will take place December 7 at the John A. Wilson Building in Washington, D.C. to discuss a proposal that would, if enacted, give optometrists there the right to prescribe opioids and other controlled substances.

Optometrists in the District of Columbia currently have one of the most restrictive scopes of practice in the US. The last legal update to the profession’s scope in D.C. occurred in April 1998, when licensed ODs in the jurisdiction became authorized to treat and manage glaucoma and administer injections for anaphylaxis. After years of stagnant policy, the mayor of D.C., Muriel Bowser, introduced a bill on October 20 called the Health Occupations Revision General Amendment Act of 2023. The proposal, sponsored by Councilmember Phil Mendelson, outlines several updates to the scope of practice of multiple allied health professionals, including optometrists, podiatrists and pharmacists. In her letter to the Council, Mayor Bowser declared that the changes are intended “for clarity or to reflect current practice trends.” 

Specifically relating to optometrists, Bill 25-0545 cites that their scope of practice should be expanded “to permit the prescribing and administering of controlled substances as related to the profession.” In other words, the pharmaceutical agents used must be “rational to the diagnosis and treatment of diseases of the human eye and its adjacent structures,” the bill defines. 

Under the current law, optometrists in D.C. can only prescribe oral immunosuppressives or medications for glaucoma. This leaves a large gap in care that can possibly delay treatment, as many patients must be referred to other providers to access needed drugs. This isn’t because optometrists are not properly trained in this service; in actuality, the clinical use of controlled substances has been taught in US optometry schools for several decades, a fact recognized by the 47 states today that permit ODs to prescribe and administer these drugs to patients. Its near-universal acceptance provides compelling evidence of the regulation’s established safety and necessity. Accompanying D.C., the only US states that also still exclude controlled substances from optometry’s scope include Hawaii, Maryland and New York.

There will be a public hearing to discuss Bill 25-0545 on December 7, being led by the Committee on Health. If you are a practicing optometrist who is unable to attend the hearing but still wishes to voice your opinion on the matter, the Committee advises in the hearing notice that “written statements are encouraged and will be made a part of the official record. Statements for the record should be submitted through the Hearing Management System or left by voicemail by calling (202) 430-6046. The record will close at 5pm on Thursday, December 21, 2023.”