Senate concurs with House amendments that expand in-office procedures optometrists may perform with certification

The Montana Senate on March 31 concurred in House amendments to House Bill 218, a measure that modernizes the statutory scope of optometry to permit specified in-office surgical and laser procedures when performed by optometrists who have completed accredited clinical training and received certification from the Montana Board of Optometry.

Senator (sponsor) Zollnikov told the Senate HB 218 was requested by Montana optometrists to update a roughly 25-year-old statute and to expand access to common, non–operating-room procedures in the front (anterior) segment of the eye. Sponsor remarks enumerated four categories of permitted procedures under the bill as amended: certain in-office minor surgical procedures (for example, removal of small lid lesions for biopsy), Nd:YAG capsulotomy for posterior capsular opacification following cataract surgery, selective laser trabeculoplasty (SLT) for glaucoma management, and peripheral iridotomy-type laser procedures to prevent acute angle-closure glaucoma. The sponsor emphasized the bill excludes penetrating intraocular surgery, intraocular injections, refractive surgery such as LASIK, and other procedures expressly reserved to ophthalmologists.

Proponents on the floor noted access benefits: the sponsor said there are about 217 licensed optometrists statewide and roughly 55 ophthalmologists, and argued that allowing certified optometrists to perform these in-office procedures would reduce travel and cost for patients in rural areas. Senators supporting the bill said the required certification and board approval would limit practice to trained clinicians. Opponents raised patient-safety concerns and urged caution, citing the need for proper training beyond academic credentialing and the importance of consumer diligence when choosing surgical care.

The Senate record shows the motion to concur was made and the bill was advanced; the floor discussion emphasized certification by the Montana Board of Optometry under 37-10-302 (transcribed as 37-10-302) as a gating requirement for optometrists to perform laser surgical procedures under the statute. Supporters framed the change as aligning Montana with peer states and expanding access in rural communities; opponents urged careful oversight and consumer protections.

Further action will follow committee and board rulemaking to implement certification requirements described in the amended statute.