American Society of Plastic Surgeons
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STATE | ASPS Fights Optometric Scope Expansion

ASPS continues to work with our state and regional plastic surgery affiliates to push back against legislation that would expand optometrists' scope of practice beyond what is appropriate for their educational and practical training. As part of this effort, ASPS also has worked closely with the American Academy of Ophthalmology and the American College of Surgeons to educate state legislatures about the limitations of optometric education and the threat to patient safety posed by over-expanding their scope.


Optometrists in Delaware have continuously advocated for legislation that would permit them to perform surgery in the eye and ocular adnexa. In an effort to preserve surgery by surgeons, ASPS launched grassroots advocacy efforts against this measure, contacting its 19 members in Delaware and requesting that they sign a joint letter. ASPS was joined by the American Academy of Ophthalmology, the American College of Surgeons, and the Delaware Medical Society in the fight against this proposal.

The Delaware Joint Sunset Commission, which examined the need to reevaluate optometrists' ability to perform surgery, did not reach a decision during the February hearing and will likely reconvene in mid-April. The Committee will determine whether the state legislature should consider legislation permitting optometrists to perform surgery. If the Committee determines that an optometric scope expansion is not necessary, the issue will not receive the support. ASPS will remain engaged on this issue and will work to preserve surgery by surgeons.


Legislation that would permit optometrists to perform injections in the ocular region has recently received traction in the Iowa state legislature. Currently, an optometrist cannot use injections other than those to counteract an anaphylactic reaction. Under the bill, an optometrist may perform injections to the ocular region, but may not administer injections that penetrate the globe. This change to existing law would allow optometrists to administer any injectable substance, from local anesthesia to cosmetic injections, to the ocular regional.

ASPS, the Iowa Society of Plastic Surgeons, the American Academy of Ophthalmology and the Iowa Academy of Ophthalmology recently opposed this legislation when it was heard by the Senate State Government Subcommittee. ASPS stressed the importance of education on injecting substances into the region and highlighted the extreme difference between epinephrine and other medical substances. The Senate State Government Subcommittee heard the bill for discussion only and has not confirmed when they will reconvene on the issue. ASPS will continue to educate legislators about the need for advanced education to administer injections to the ocular region.


ASPS and the Northwest Society of Plastic Surgeons preemptively wrote to the Alaska State Senate Labor and Commerce Committee expressing concern with legislation allowing optometrists to perform surgical procedures in the ocular region. ASPS stressed that by allowing optometrists to practice medicine without the requisite medical school and residency training patient safety seriously would be jeopardized and the standards of surgical care in the state would be diminished.

While this bill has not been called for a hearing, ASPS and the Northwest Society wrote to the committee chair in hopes of deterring the chair from moving the bill. The American Academy of Ophthalmology has also been engaged on this issue and is working closely with ASPS to preserve surgery by surgeons.