Senate committee lays over bill to expand optometrists' prescribing and injection authority after hours of testimony

The Senate Health and Human Services Finance and Policy Committee laid over Senate File 1144 on Tuesday after a lengthy hearing that featured competing testimony from optometrists seeking expanded scope of practice and ophthalmologists urging caution.

Senator McQuaid, sponsor of SF 1144, told the committee the bill would modernize optometry's scope by allowing doctors of optometry to prescribe oral antivirals for ocular conditions, permit oral steroids for up to 14 days, remove a seven-day limit on certain oral carbonic anhydrase inhibitors used to lower eye pressure, and allow routine injections for specified, limited in-office procedures. "This bill isn't doing anything scary or new. It's really just bringing us in line," McQuaid said, noting many neighboring states have broader optometry authorities.

Optometrists and representatives testified in support, saying the changes would increase access to timely eye care, particularly in rural and underserved areas. Randy Kemper, a practicing optometrist and past president of the Minnesota Optometric Association, told the committee the bill "modernizes eye care, ensuring patients can access the treatment they need from trusted providers with the training to make complex medical decisions." He and other proponents emphasized training, state-board oversight and continuing education as safeguards.

Ophthalmologists and teaching hospitals testified in opposition or urged limits, citing patient safety and differences in training. Amanda Moultrie, president of the Minnesota Academy of Eye Physicians and Surgeons and a practicing ophthalmologist, said ophthalmologists complete medical school and extensive surgical training and warned that injections and certain procedures around the eye can cause severe harm if performed incorrectly. "These are not minor [complications], and they require a physician who, after dedicating tens of thousands of hours in apprenticeship style training, has gained the skill and the judgment to perform these surgeries safely," Moultrie said.

Other opponents included surgical subspecialists and academic-affiliated physicians who described rare but severe complications from injections near the eye, and a patient who recounted urgent care that led to a neuro-ophthalmology referral and an MRI diagnosis. Professor Akshay Rao, who described his own care trajectory after COVID-related illness and subsequent double vision, credited an ophthalmologist with prompt diagnosis that led to treatment that "effectively saved my life."

Committee members debated rural access versus safety. Several senators, including members from rural districts, said expanded optometry scope could reduce travel time and wait lists for routine care. Others urged targeted guardrails for vulnerable populations (children, elderly, immunocompromised), specific exclusions for high-risk injections and clear continuing-education requirements.

Senators described a multi-year negotiation history on scope changes. The sponsor and others noted that parts of the bill reflect language agreed in previous committee sessions and that some provisions previously were included in the senate omnibus package. After extended discussion the committee laid the bill over to allow time for additional work and possible inclusion in a broader professional-licensing package. No final committee vote on passage took place on SF 1144 at this hearing.

Ending: Lawmakers said they will continue stakeholder negotiations, and the committee will revisit the bill or related omnibus language before deciding whether to pass the measure to the floor.