Montana Gov. Greg Gianforte signed new legislation into law last month authorizing board-certified optometrists (ODs) across the state to perform laser and minor surgical procedures.
This marks a major win for the optometric community’s cross-country efforts to expand scope of practice—and a stark contrast to the recent vetoing of a similar bill proposed in New Mexico.
How exciting! Let’s start with this bill.
Initially introduced into the Montana House of Representatives in January, House Bill (H.B.) 218 amends the practice of optometry in the state to “allow licensed optometrists to perform certain in-office surgical procedures and laser surgical procedures.”
Notably: These procedures are specifically limited to the anterior segment of the eye and adenexa—and exclude the following:
- Penetrating intraocular surgery
- Refractive surgery
- Intravitreal injection
And how did this change previous state law?
In the state’s definition of what constitutes the practice of optometry, H.B. 218 removed a section that read: “Does not allow an optometrist to perform surgery or laser surgery for any purpose.”
Got it. So what requirements do these licensed ODs need to meet for this?
The bill stipulates that an OD must be verified and certified by the Montana Board of Optometry that they have successfully completed “the required … clinical training from an accredited optometry school or college.”
- Further: This training must cover the use of lasers “for medically recognized and appropriate treatment of the human eye,” the law states.
Any other changes made?
Prior to H.B. 218, ODs were permitted to:
- Topically administer only a select number of drugs for examination purposes (cycloplegics, mydriatics, topical anesthetics, dyes such as fluorescein, and miotics—for emergency purposes only)
- The update: ODs are no longer limited to just those drugs for “detecting any condition of the process of vision that may have any significance in a complete optometric eye and vision examination.”
Nice! So when will this update take effect?
July 1.
Important to note: This will make Montana the 13th U.S. state authorizing ODs to perform some form of surgical procedures.
Let’s talk big picture on scope expansion across the country.
It’s a mixed bag, really.
Some states (like South Dakota, for example) have had recent success in passing legislation—ODs are now allowed to perform certain advanced procedures—while New Mexico, as we mentioned, had its governor reject an attempt to permit ODs two specific laser procedures—despite that legislation passing in the state’s House and Senate.
Why reject such legislation?
In vetoing the bill, New Mexico’s governor stated that the legislation would have“set a dangerous precedent” for allowing ODs (referred to as “non-surgeons”) to perform surgical procedures.
- See here for that reasoning—which, as we noted in our coverage, lacked supporting data and references to validate the claims.
And directly contradicting this rejection: Recent research published in Clinical and Experimental Optometry investigated education programs aimed at training ODs on laser procedures and injections.
Including in those findings, the authors determined that
- ODs are performing laser procedures safely—with “all U.S.-based optometry colleges and schools [offering] courses on lasers and injectables for their students.”
*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.