Senate committee hears testimony on S.64 to expand optometrists’ scope to include lasers, eyelid procedures

The Senate Committee on Government Operations took public testimony Feb. 25 on S.64, a bill that would amend the scope of practice for optometrists to authorize certain laser procedures and minor eyelid treatments.

Dr. Guy Timothy Petito, a practitioner in St. Petersburg, Florida, and chair of the Accreditation Council on Optometric Education, told the committee that accreditation and licensure systems ensure educational programs teach the skills underlying contemporary optometric practice. "The process that ensures the educational content supports the clinical practice for every provider in every specialty in the United States is the accreditation process," Petito said.

Petito said the Accreditation Council on Optometric Education (the programmatic accreditor for optometry) adopted a definition of "contemporary optometry" that takes effect in the current standards cycle and that the new standard references procedures allowable in at least 10% of states' scopes of practice. "This definition includes evaluation, diagnosis, treatment and management of refractive conditions, diseases of the eye and associated systems, rehabilitation, normalization, and enhancement of the visual system," he said.

Dr. Nate Lighthizer, dean of the Oklahoma College of Optometry, described longtime training and practice in states that allow advanced procedures. Lighthizer said Oklahoma has trained practitioners and visiting faculty for other U.S. schools for years and that clinical education evolved gradually. He told senators he has performed more than 5,000 laser procedures in Oklahoma and cited a multi‑state review of roughly 46,000 procedures that, in his words, identified two unintended adverse outcomes in that dataset.

Committee members asked about safety, comparative outcomes, and unintended consequences in states that have expanded optometrists' scopes. Senator White asked whether a widely cited study alleging a Medicare-era increase in repeat laser procedures after optometrists gained authorization in Oklahoma was an accurate portrayal. Lighthizer said the finding could reflect differences in how earlier and newer lasers were used (180‑degree vs. 360‑degree treatment patterns) and billing patterns rather than poorer outcomes. "The explanation in that study is this: when you do this laser called an SLT ... you can do that 360 degrees ... or you can do it 180 degrees," he said, noting practice patterns changed as technology evolved.

Petito outlined the governance and timing of accreditation standards: programmatic reaccreditation reviews begin on a five‑year cycle with about two years of review activity; the national oversight body that reviews accreditors begins its reaccreditation on a seven‑year cycle. He said the relevant optometry standard set became active Jan. 1, 2025, and that schools began teaching the procedures at different points, with the transcript testimony referencing curriculum changes implemented by Feb. 2017 and graduates from the February 2019 class onward having associated training.

Witnesses and senators discussed access to care and workforce implications. Lighthizer and others said broader scopes can help retain graduates and increase local access: he said roughly 81% of his program’s graduates remained in Oklahoma and that graduates frequently stay in states where they may practice to the full extent of their training. Witnesses also said Canada, the U.K. and Australia are considering or expanding advanced optometric procedures, though the United States was described as having among the most comprehensive optometric educational standards.

No formal motion or vote on S.64 was recorded in the transcript of the session. The committee recessed after testimony and planned to resume later in the agenda; the next scheduled item mentioned in the transcript was S.58, concerning law enforcement and firefighter personnel matters.

Why this matters: the committee is weighing whether to change the statutory scope of practice for a licensed health profession. Supporters told senators accreditation, licensure and continuing oversight already align clinical training with the proposed activities; senators pressed witnesses on safety, billing and workforce impacts and sought source studies to corroborate empirical claims.

Looking ahead: the committee did not take final action during the testimony recorded in the transcript. Additional hearings, requests for documents (including studies cited in testimony), and potential bill amendments were discussed as next steps by committee members.