New legislation enabling optometrists (ODs) to perform multiple advanced procedures is scheduled to take effect in South Dakota this summer, building on the growing number of scope of practice expansion bills across the United States.
First, give me an update on OD scope expansion in the U.S.
As of March 2024, 10 states have passed legislation to permit ODs to perform a range of surgical procedures. These include:
- Alaska
- Arkansas
- Colorado
- Indiana
- Kentucky
- Louisiana
- MIssissippi
- Oklahoma
- Wyoming
- Virginia
See here for an in-depth dive into which procedures are allowed in which states, as well as ODs’ specific scopes of practice in each.
Also, we’d be remiss if we didn’t say that Wisconsin deserves an honorable mention as #11 on this list, as practicing ODs in the state are currently allowed to perform such procedures—including laser—within their scope.
To note: Wisconsin’s scope of practice has not been amended since its establishment in 1990.
Tell me more about this legislation.
South Dakota Gov. Kristi Noem (R) signed into law House Bill (HB) 1099 on March 5, 2024, which officially seeks to establish education standards for ODs’ expanded scope of practice.
Essentially, the bill enables ODs to perform advanced procedures such as:
- Selective laser trabeculoplasty (SLT)
- Yttrium aluminum garnet (YAG) laser for posterior capsulotomy
- Injections for:
- BOTOX (OnabotulinumtoxinA) around the eye (medical necessity only)
- Local anesthetic via injection for pedunculated skin tag removal
- Steroid via injection for chalazion
Any other notable changes?
The bill also notes intense pulsed light (IPL) therapy as a permissible treatment by ODs for dry eye disease (DED), resolving an ongoing, in-state legal battle surrounding ODs’ use of Intense pulsed light (IPL) therapy.
I need some background on this, please.
South Dakota ODs were originally granted the right to perform IPL as a nonsurgical treatment for DED in September 2023 after the South Dakota Optometric Society (SDOS) submitted a petition to the state’s Board of Examiners.
However, the South Dakota Academy of Ophthalmology (SDAO) later filed an appeal against the ruling, arguing that IPL was not within the state’s OD scope of practice.
Needless to say, that pending case has been voided.
Was there any opposition to HB 1099?
Oh, yes. In a statement to Glance, SDOA noted that the bill was opposed by multiple state organizations:
- South Dakota Academy of Ophthalmology
- South Dakota State Medical Society
- Specialty hospitals and various dermatologists around the state
Gotcha. So what kind of training is required for ODs to perform these procedures?
In order for an OD to perform such procedures, they must complete an additional three requirements:
- Passed the National Board of Examiners in Optometry (NBEO) laser and surgical procedures examinations, or
- Graduated from an accredited optometric program approved by the Accreditation Council on Optometric Education (ACOE) in the U.S. and Canada, or another optometric school approved by the NBEO
- Completed a 32-hour, NBEO-approved course on all procedures-related content with the proctored by an ophthalmologist or OD authorized to perform all procedures. Demonstrated competency aligned with all necessary performance criteria (above)
So how has the state’s optometric association reacted to this new bill?
In a statement to Glance, SDOA Executive Director Deb Mortenson expressed her enthusiasm over HB 1099. “I am so proud of our member doctors for the support they provided in passing this bill,” she wrote. “When asked, they responded and met with legislators, texted, allied, and emailed … several ODs made the trip to the state Capitol to lobby legislators and testify in committee.”
Any other notable legislation to be aware of?
Click here for all of our recent legislation coverage.
*Disclaimer: The information provided in this article does not and is not intended to constitute legal advice; instead, all information, content, materials available herein are for general information purposes only.