Tennessee Gov. Bill Lee signed new legislation into law last week authorizing board-certified optometrists (ODs) across the state to perform specific in-office laser procedures.
This bill marks Tennessee as the 16th state overall to expand ODs’ scope of practice via ophthalmic laser.
Didn’t we just hear about similar news … ?
Yes! However, not for Tennessee.
In just the last couple of months, optometry scope of expansion bills have had their wins and losses throughout the country:
- March 2026: A Texas district judge blocked a vision plan law restricting vision benefit managers’ (VBMs’) power over ODs and patients.
- March 2026: Kansas passed legislation permitting ODs to perform select ophthalmic surgeries while requiring new training and credential standards
- April 2026: New Hampshire’s governor rejected legislation that would have allowed ODs to perform three ophthalmic (laser) procedures (see her reasoning for the veto).
Definitely some ups and downs … now let’s talk about this new bill.
Initially introduced into the Tennessee Senate in January and passed by both the House and Senate last month, Senate Bill (S.B.) 2076 amends the state’s practice of optometry to enable licensed ODs to perform three in-office laser procedures:
- Yttrium aluminum garnet (YAG) capsulotomy
- Selective laser trabeculoplasty (SLT)
- Laser peripheral iridotomy (LPI)
Can you get more specific?
The bill clarifies that ODs may “diagnose, manage, prevent, and treat conditions and diseases of the eyelids and eyes”—which extends to utilizing laser procedures for the anterior segment of the eye—as well as:
- Administering and prescribing medications
- Performing diagnostic tests
- Using local anesthetics for specific eyelid and eye adnexa procedures
Regarding lasers … any limitations attached to these?
But of course … in order to perform such procedures, ODs must be approved by the Board of Optometry, which will determine the specific training and education required for these added privileges.
Importantly: This scope of expansion prohibits ODs from performing a few specific surgical procedures, including:
- Retina laser procedures
- Laser-assisted in situ keratomileusis (LASIK)
- Corneal transplants
- Cataract surgery
- Any non-laser surgery involving the cornea, sclera, iris, ciliary body, vitreous, or retina
And for local anesthetic use—what does this include?
It extends to the ability to administer certain local anesthesia for specific eyelid and eye adnexa procedures for:
- Intramuscular pharmaceuticals
- Subcutaneous pharmaceuticals
- Intradermal pharmaceuticals
To note: This also extends to local anesthesia administered via anesthetic / therapeutic injection (such as facial aging treatments).
And what certification must an OD obtain?
To perform anesthesia, the bill states that an OD must provide proof of the following to the Board:
- A current cardiopulmonary resuscitation (CPR) certification by a Board-approved organization
- An automated external defibrillator (AED) present at all times in their clinical practice where local anesthesia is administered
How about to perform those aforementioned procedures?
The state’s Board of Optometry will have the authority to determine the specific education, training, and education that Tennessee’s ODs are required to have in order to conduct the surgical procedures.
- Regarding this training: Senate supporters of the bill previously referenced “training pathways” offered through the Southern College of Optometry.
And take note: The bill emphasized that ODs will “be held to the same standard of care as that of other physicians providing similar services.”
Got it. So, I imagine there was some opposition to this
But of course.
Prior to S.B. 2760’s passing, practicing ophthalmologists voiced “serious safety concerns” over the legislation to the state’s Senate Health Committee, particularly in regards to patient-safety and complication risks. See here for details on this argument.
And following its passing: The American Academy of Ophthalmology (AAO) published coverage of for Academy members, in which the preview text reads “A dangerous new laser surgery bill, Senate Bill 2076/House Bill 1952, was introduced in the Tennessee legislature.”
And the reaction among the optometric community?
As to be expected, the response has been overwhelmingly positive.
Case in point: American Optometric Association (AOA) President Jacquie M. Bowen, OD, noted that this latest scope of practice is about more than one state.
- “It’s part of a growing, nationwide movement to ensure patients have access to the full scope of care doctors of optometry are trained to provide,” she stated. “The AOA is proud to stand alongside our affiliates as we continue advancing this progress across the country.”
And closer to home?
Amanda Dellinger, OD, Legislative Committee co-chair for the Tennessee Optometric Association of Physicians’ (TOAP), referred to the bill as a “landmark victory,” following years of advocacy from state ODs.
- “This law modernizes our state’s optometric scope to reflect the education and clinical training doctors of optometry receive today, positioning Tennessee as a leader in modern, patient-centered eye care and helping to ensure more patients can get the care they need, when and where they need it.”
So when will the bill actually go into effect?
Two (vastly different) timeframes to be aware of:
- A portion of the legislation will take effect immediately to enable the state’s Board to promulgate (formally put into effect) the new rules.
- Other provisions within the bill will take Jan. 1, 2028.
*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.