Support SB 120 by Senator Del Marsh  (House sponsor Rep. Danny Garrett)
Optometric Scope Expansion

Click HERE for a copy of Senate Bill 120

Click HERE for information on optometric education

Click HERE for information on access to eyecare in Alabama

Click HERE for a sample of certification requirements from other states

Click HERE for letters from licensing boards on outcomes from laser procedures

Click HERE for a scope map

Click HERE for a video of a YAG procedure from a patient perspective

Doctors of Optometry, who practice throughout this state, enable Alabamians to have local access to safe, quality primary eye health care.  

Alabama's optometry law has not been significantly updated since 1995, but medicine has changed dramatically since then. In order to continue to bring the highest quality eye and vision care to our citizens, our optometry law needs to be updated to reflect the changes in education and technology.  

What Does This Bill Do?

  • This bill will expand access to care for all Alabamians by allowing Doctors of Optometry to perform limited laser procedures in their offices, lessening travel time and expenses for many patients.
  • These in-office procedures do not require general anesthesia.
  • Doctors of Optometry will be able to treat the same conditions that they have always diagnosed without patients having to schedule an appointment with another medical professional, saving them time and money.
  • This will not broaden the scope of what conditions optometrists currently manage and/or treat. Instead it will enable optometrists to utilize the latest technologies to bring their patients the best possible care.  

Examples of Procedures Included In This Bill

  • YAG Capsulotomy (YAG) - Common in-office procedure to open cloudy film on lens implant after cataract surgery.
  • Laser Peripheral Iridotomy (PI) - Emergency sight-saving procedure to treat elevated intraocular pressure from glaucoma.
  • Selective Laser Trabeculoplasty (SLT) - Common in-office procedure to treat elevated intraocular pressure from glaucoma.
  • Removal and Identification of Skin Lesions Around Eye - Common in-office procedure to remove benign lesions around the eye.
  • Injections - This bill would include injections near the eye and only within the most superficial layer of the eye. This would include subcutaneous, intramuscular and subconjunctival injections.    

Other States Are Leading The Way On This Issue

Doctors of Optometry in other states have been performing these procedures for 20 years.  The states that have already passed legislation to allow these procedures have seen no increase in malpractice premiums:

  •  Oklahoma (1998)
  •  Kentucky (2011)
  •  Louisiana (2014)
  •  Alaska (2017)
  •  Arkansas (2019)    
  •  Mississippi (2021)
  •  Wyoming (2021)
  •  Virginia (2022)

These Procedures Are Being Taught in Optometry School

  • Optometry schools have already incorporated these procedures into their curriculums.
  • Doctors of optometry receive extensive training in a 4-year program dedicated to learning about the eye and vision care. This is after receiving an undergraduate degree. Many optometrists in Alabama have additionally completed residency training.
  • New graduates from optometry school are now choosing to practice in other states because Alabama doesn't allow them to use the latest technology and practice to the fullest extent of their training. For Alabama to continue to attract some of the best graduates from optometry schools, we must update our laws to allow them to practice at the forefront of optometry.
  • Many practicing doctors have taken additional extensive coursework for further training in lasers and other advanced procedures.
  • Most practicing MDs utilize technologies that they did not learn in medical school or residency. Why? Because the latest technologies and procedures were not invented until after they entered practice. These fine medical doctors learn to do these things by going to continuing education courses, not going back for years of medical school.  Optometrists do the same thing.  

Why Is This Good For Alabama?

  • This bill will expand access for all Alabamians by allowing patients to undergo certain procedures at their optometrist's office when more convenient than the nearest ophthalmology office.
  • According to a study conducted by The Eyesight Foundation in 2010, Doctors of Optometry have locations in 57 counties in Alabama.  Ophthalmologists have locations in only 24 counties, making it more difficult for some of our citizens to receive the care they need.  

Other Points

  • President Trump's administration released a report in 2018 supporting scope expansion in the states.   In the Reforming America's Healthcare System Through Choice and Competition, the administration advocated for scope expansion as a part of reform of the healthcare system and specifically named optometrists as one of the providers that can safely and "effectively provide some of the same healthcare services as physicians, in addition to providing complementary service."
  • This bill maintains the prohibition on optometrists prescribing hydrocodone.  This should further highlight that the new procedures included in this bill are minor, in-office procedures that do not rise to the level of needing an opioid for pain relief.