New bipartisan legislation recently passed into Minnesota law grants in-state-practicing optometrists (ODs) the first optometric scope of expansion in over 20 years.
First things first: this bill.
Referred to as a health policy bill, House File (HF) 2464 includes—among several other provisions—updates to the state’s current optometric law regarding medication prescribing and in-office injections.
- Enables ODs to administer some in-office injections
- Removes restrictions on ODs’ prescriptions of oral viral medications
- Allows ODs to prescribe oral steroids
- Removes restrictions on oral carbonic anhydrase inhibitors (CAIs)
Start with these in-office injections
Per the state’s previous law: ODs were not permitted to administer any injections to patients.
And the updated law: Permits ODs to administer in-office injections for chalazion (minor eyelid issues).
- Specifically, these injections may extend to:
- Local anesthesia
- Paralytic agents (including for cosmetic purposes)
- Includes botulinum toxin, limited to the periocular muscles
- Removing lesions (5 mm or smaller)
Importantly: These permitted injections do not apply to those for treating anaphylaxis.
Are there any requirements that an OD must fulfill before performing those?
The bill notes that an OD must first receive approval from the state’s Board of Optometry after demonstrating that they have “sufficient educational or clinical training to perform injections.”
And take note: This makes Minnesota the latest state (out of 25+) already allowing such OD-performed injections to treat ocular conditions.
Gotcha. Now to those prescription updates.
In regard to oral antiviral medications:
- Old law: ODs were permitted to prescribe oral antivirals for up to 10 days
- Updated law: ODs now have an unlimited timeframe in which they can prescribe oral antivirals
- In alignment with 48 other states
And for oral steroid medications:
- Old law: ODs were blocked from prescribing oral steroids
- Updated law: ODs are now permitted to prescribe oral steroids for up to 14 days without needing to consult with a physician (MD)
- In alignment with 44 other states
How about for those CAIs?
To note: Part of the diuretic class of medications, CAIs are used to manage and treat glaucoma by lowering intraocular pressure (IOP).
- Per the old law: ODs were not permitted to prescribe or administer CAs for more than 7 days
- Under the updated law: ODs are no longer restricted to 7 days for prescribing or administering CAIs
- In alignment with 44 other states
So! When will these updates take effect?
The changes to ODs’ use of oral medication will reportedly go into effect in August.
Per Randy Kempfer, OD, advocacy director for the Minnesota Optometric Association (MOA), the new injection permissions will “go into effect later,” according to reporting by the American Optometric Association (AOA).
- No specific timeframe was provided.
And how, exactly, did we get to this point in Minnesota?
Prior to HF2464, Minnesota was ranked in the bottom 20% nationwide for optometry scope of practice—with in-state ODs “forced to practice outdated optometry,” according to a 2025 report by the Minnesota State Senate’s Committee on Finance.
Efforts to introduce these changes were first introduced into the state legislature in 2018. However, those were later halted in 2020 following an early March 2020 hearing due to the COVID-19 pandemic.
- See here for a timeline of events leading up to 2024 (starting with the initial concept for scope changes in 2014) involving state legislatures and members of the MOA.
Let’s talk big picture on scope expansion across the country.
Changes to optometric law are coming to states around the U.S., with recent legislative expansion success (and a notable rejection) in the following states just over the last few months:
- South Dakota: ODs now allowed to perform certain advanced procedures
- New Mexico: Failed attempt to permit ODs two specific laser procedures following governor’s rejection
- West Virginia: ODs permitted to perform in-office ophthalmic laser procedures
- Montana: ODs granted permission to perform in-office laser and surgical procedures
See here for more legislative developments and news.
*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.