Vermont committee hears split testimony on S.64 to expand optometrists' surgical scope

The Senate Committee on Government Operations heard more than two hours of testimony Feb. 26 on S.64, a bill that would amend optometry scope-of-practice law to allow qualified optometrists to perform specified laser and minor ocular procedures.

Supporters of the bill, including optometry educators and a current optometry resident, told the committee that modern optometry education and supervised clinical training prepare graduates to perform the procedures safely and that expanding scope would improve access to care. Opponents — including the chair of the Vermont Board of Medical Practice and representatives of specialty medical boards — said there is insufficient evidence that expansion improves access or lowers costs and argued the proposed training, supervision and assessment provisions in S.64 are inadequate to protect patient safety.

Why it matters: The dispute centers on whether the incremental surgical and laser procedures in S.64 can be learned and practiced safely with the training and oversight the bill specifies, and whether expansion would meaningfully increase access to care in rural Vermont. Committee members pressed witnesses on evidence, case-volume thresholds, continuing-assessment requirements, and differences between optometry and ophthalmology training paths.

Rick Hildebrandt, chair of the Vermont Board of Medical Practice, told the committee the board “unanimously voted against supporting the expansion of optometry scope of practice” in October 2023 and again expressed no support after a January review because “no new evidence had emerged.” He cited three core concerns from the board: the Office of…