Montana's House Bill 218 is stirring significant debate as it seeks to expand the scope of practice for optometrists in the state. Introduced on April 1, 2025, the bill aims to allow certified optometrists to perform certain in-office surgical and laser procedures on the anterior segment of the eye, a move that could reshape eye care accessibility in Montana.

The bill specifies that while optometrists can remove foreign bodies from the eye, they are prohibited from conducting penetrating intraocular surgeries, intravitreal injections, and refractive surgeries unless they hold specific certifications. This certification process, governed by the state’s board of optometry, requires optometrists to complete rigorous training in laser procedures, ensuring that only qualified professionals can perform these advanced treatments.

Supporters of HB 218 argue that expanding optometrists' capabilities will enhance patient care by reducing wait times for procedures and increasing access to eye health services, especially in rural areas where ophthalmologists may be scarce. "This bill is about empowering optometrists to provide more comprehensive care," said a proponent during legislative discussions.

However, the bill faces opposition from some ophthalmologists and medical professionals who express concerns over patient safety and the adequacy of training for optometrists to perform surgical procedures. Critics argue that the complexities of eye surgery require a higher level of expertise than what is typically covered in optometry training. "We need to ensure that patients receive the highest standard of care, which may not be guaranteed with this expansion," stated a representative from the Montana Ophthalmological Society.

As the bill progresses through the legislative process, its implications could be far-reaching. If passed, HB 218 may not only alter the landscape of eye care in Montana but also set a precedent for similar legislative efforts in other states. The ongoing discussions highlight a critical intersection of healthcare access, professional scope, and patient safety, making this bill a focal point of interest for both medical professionals and the public alike. The next steps will involve further debates and potential amendments as lawmakers weigh the benefits against the risks associated with this significant shift in optometric practice.