Vermont’s optometry at a crossroads
Vermont lawmakers are considering legislation that could significantly expand the scope of practice for optometrists, a move supporters say would improve access to eye care—particularly in rural areas—while maintaining patient safety.
Senate Bill S.64 and House Bill H.241 would authorize Vermont optometrists to perform certain advanced in‑office procedures, including selective laser treatments, ocular injections, and minor eyelid lesion removals. To do so, optometrists would be required to obtain a new “advanced procedures specialty” license, complete additional training, and meet stringent regulatory requirements overseen by the state.
Currently, Vermont optometrists provide primary eye care statewide, diagnosing and managing common ocular conditions, prescribing corrective lenses, and referring patients to ophthalmologists for surgery and post‑operative care. However, advanced procedures are limited to ophthalmologists, which critics argue contributes to delays in care, especially in rural regions where access to specialty providers can be limited.
Proponents of the legislation say modernization is necessary to keep pace with evolving clinical standards and patient needs. Recent optometry graduates complete nearly 10,000 hours of clinical education and thousands of patient encounters, including training in laser and injection techniques that reflect national accreditation standards. Many states allow optometrists to use this training immediately upon licensure.
Nationally, 25 states permit a broader optometric scope of practice than Vermont, with 14 states authorizing all the procedures outlined in the pending bills. States such as Oklahoma, Kentucky, and Louisiana report no rise in patient safety incidents or malpractice claims following similar expansions. Meanwhile, neighboring New Hampshire is also considering legislation to expand optometric practice.
Supporters emphasize that the proposal does not aim to replace ophthalmologists but to strengthen the eye‑care system by allowing each profession to practice at the top of its training. The Vermont bills would establish some of the most rigorous qualification standards in the nation, exceeding the continuing education requirements used in many other states.
Dean Barcelow, Bethel
Dr. Bareclow is an optometrist at Eye Care for You.