American Society of Plastic Surgeons
For Consumers

Wave of Bills Seeks to Expand Optometrists' Scope

The 2021 legislative season has seen another wave of bills seeking to grant non-physician providers the ability to practice medicine, as various states have introduced or passed bills to expand scope of practice. A predominant trend in legislative chambers is policy in favor of allowing optometrists to perform surgical procedures that fall squarely within the practice of medicine.

ASPS has been actively tracking these efforts, as well as working with state partners to oppose legislation with significant implications for both the practice and patient care.


While the degree to which optometrists' scope would be expanded varies by state, the wave of legislation has been consistent across the country; representing a concerted and coordinated effort on behalf of optometry practice. Some bills allow optometrists to perform surgical procedures, while others permit the utilization of lasers or authorize the administration of botox/fillers.

At the time of writing, legislation has been introduced in Alabama, Florida, Mississippi, Oklahoma, Oregon, Texas, Wisconsin and Wyoming. Bills have been signed into law in Mississippi and Wyoming.

ASPS at the table

The Society has been actively working to respond to this recent raft of scope of practice legislation and weighing in on overreaching bills that would extend rights to optometrists beyond their training.

In a letter to Mississippi Governor Tate Reeves, ASPS and the Southeastern Society of Plastic & Reconstructive Surgeons (SESPRS) urged the Governor to, "maintain the high level of patient care that has been established and preserve current standards that permit surgery in the ocular region only by licensed medical doctors (MDs) or doctors of osteopathic medicine (DOs) who meet appropriate education, training and professional standards." The Mississippi legislation, which the Governor ultimately signed into law, allows scope expansions for optometrists but prevents them from providing injections and dermal fillers.

ASPS also worked with SESPRS to oppose efforts in Oklahoma to expand the scope of optometrists and grant significant power to the state's optometry board by directing the Oklahoma Board of Examiners to adopt rules regarding ophthalmic surgery within the practice of optometry. In a joint letter to state legislative leaders, ASPS and SESPRS cautioned against the move, which would, "promulgate rules regarding ophthalmic surgery, as it clearly falls within the scope of medicine...[and allow] a nonmedical board to oversee procedures that fall firmly within the practice of medicine."

In Wyoming, the Society collaborated with the Mountain West Society of Plastic Surgeons (MWSPS) to oppose harmful efforts to expand optometrists' scope in the state.

Key victories

In Alabama, ASPS worked with the Plastic Surgery Society of Alabama (PSSA) to oppose a bill – S.B. 174 – that would have expanded optometrists' scope. In a joint letter to legislative leaders, ASPS and PSSA outlined concerns with the bill, which would have also directed the Alabama Board of Optometry to adopt rules regarding ophthalmic surgery within the practice of optometry.

Following these comments, the state legislature indefinitely postponed the bill and adjourned in May with no further action on S.B. 174. A proposal to expand optometrists' scope in Florida also failed to pass when the state's legislature adjourned, representing an important win for the Society and the Florida Society of Plastic Surgeons (FSPS).

Continuing the fight

As legislative sessions adjourn and a handful of states remain in session, ASPS will be monitoring this issue and working to oppose any measure that would jeopardize patient safety and lower the standard of care by granting non-physicians the ability to perform ophthalmic surgical procedures. As this work progresses, ASPS will continue to work with state and regional plastic surgery societies, state medical societies and the American Academy of Ophthalmology to ensure the best outcomes for patients and surgeons.