Board members discussed an increasing number of noninvasive devices marketed for eyelid tightening, meibomian gland dysfunction and other ocular-surface and periocular conditions. Members said the devices use light, radiofrequency and interchangeable treatment heads and that multiple manufacturers are entering the market.

The board's secretary-treasurer (name not specified) described the devices as "noninvasive procedure[s], not making any incisions on the skin," and noted that "at this point in time, we have had the position, We're not supportive or denying either." He said the practical limits now include lack of reimbursable insurance codes and high equipment costs. "To get into some of these instruments, you're looking at $100,125,000 dollars," he said in the discussion (transcript phrasing retained).

Members also raised questions about who may lawfully perform these procedures. The secretary-treasurer noted that for similar technologies, like IPL, aestheticians or persons without a state license sometimes perform treatments in some settings, which affects board thinking about whether optometrists should have expanded scope for these services. Legal counsel was asked whether the board has options for setting scope limits and whether the matter required referral for formal opinion; the board said an item had been sent to the district attorney's office for review.

Why this matters: New ophthalmic and periocular treatment devices blur lines between cosmetic and medical care, raise reimbursement and liability questions, and may affect scope-of-practice decisions. Board members said they currently view these technologies consistently with prior instrument reviews and will revisit specific instruments if DA or staff legal guidance recommends changes.

Next steps: The board asked staff to post the information received from Todd Fleischer (KOA) and to have legal counsel or a designee review and return with a recommendation on whether to change the board's guidance; the board will monitor DA and legal-review outcomes.