Edward J. Timmons, director of the Knee Regulatory Research Center at West Virginia University, told the joint committee on government organization on Sept. 8 that expanding the scope of practice for optometrists can increase access to care and reduce vision impairment. "By granting optometrists this permission, by allowing optometrists to provide treatment to patients for glaucoma, we observed a 12% reduction in vision impairment nationwide," Timmons said during his presentation.

Timmons gave the committee an overview of eye-care roles and said ophthalmologists are medical doctors who perform surgery while optometrists, who complete four years of optometry school, provide clinical treatment and sometimes postgraduate training. He told members that many states are expanding optometrist authority and that West Virginia was an early adopter of therapeutic pharmaceutical prescribing for optometrists.

Why it matters: Timmons framed the change as a response to supply shortages in ophthalmology and uneven geographic access. "There just aren't as many people completing residences in ophthalmology," he said, arguing that giving optometrists additional authority can make treatment more available to patients who otherwise face travel delays or provider scarcity.

Evidence presented: Timmons cited a recent multi-jurisdictional study that examined laser procedures performed by optometrists and reported only two documented complaints in the dataset he discussed. He contrasted that with earlier Oklahoma data showing higher rates of repeat procedures near the time that state first permitted optometrist-performed laser work, and he described these earlier results as possible evidence of early learning curves rather than enduring problems. Timmons emphasized that optometrists undertaking laser procedures complete additional postgraduate training in states that authorize that care.

Committee questions focused on student retention, clinical competence and consumer costs. A committee member asked whether expanded optometrist practice would lower costs for patients; Timmons said direct eye-care cost studies are limited but cited analogous findings for nurse practitioners that suggest lower patient costs are possible. When asked about diagnostic ability and educational standards, Timmons reiterated that residencies for ophthalmologists are required while optometry residencies are optional and that, in authorized areas, optometrists appear to be competent to diagnose conditions such as glaucoma.

What’s next: Timmons offered to provide follow-up studies and data on procedure outcomes, training requirements and state-by-state differences. The committee did not take formal action on optometry scope at the Sept. 8 meeting and adjourned after questions.