Doctors of optometry have safely performed thousands of optometric laser procedures

Out of 146,403 optometric laser procedures performed by U.S. doctors of optometry in 12 states, only two (0.001%) had “negative outcomes” or complications, a new review says.

A historic and growing number of U.S. states currently allow doctors of optometry to perform office-based laser procedures: Oklahoma, Kentucky, Louisiana, Alaska, Indiana, Arkansas, Mississippi, Wyoming, Wisconsin, Virginia, Colorado and South Dakota. Oklahoma optometrists were the first in 1988 and South Dakota the latest. Authorization to perform laser surgeries has also been granted to optometrists in the United Kingdom and New Zealand.

The results of the review, “Establishment and review of educational programs to train optometrists in laser procedures and injections,” appear in the July 24 issue of Clinical and Experimental Optometry and underscore two findings in the review:

• Doctors of optometry are performing the laser procedures safely.
• Education is key to that patient safety.

Opponents of extending laser procedure authority to doctors of optometry have cited safety as an issue. But the review proves the opposite.

“These metrics outline the effectiveness of these procedures performed by optometrists and show strong support for future optometric scope expansion,” the authors write. “Eye health professionals, relevant educational institutions, advocacy groups, and policymakers are called upon to work collaboratively to expand the optometric scope of practice globally.”

Critics of extending laser procedure authority to doctors of optometry have cited safety as an issue. But the review proves the opposite.

Says Nathan Lighthizer, O.D., the study’s lead author and dean of Northeastern State University Oklahoma College of Optometry: “It confirms what all of us knew already—that doctors of optometry are the most qualified to be performing laser procedures. We have a 30-plus-year track record in Oklahoma and 10-plus years in other states.

“Optometry is highly trained, highly skilled and highly qualified to care for our patients with laser procedures,” he adds. “This study provides us the data from more than 146,000 patients that optometry performs the procedure well and very safely.”

Role of optometric education in patient safety

According to the review, all U.S.-based optometry colleges and schools offer courses on lasers and injectables for their students. The authors link that safety record to the education and training of optometrists.

“The results tell us that optometry is teaching optometry students and optometrists post-graduation extremely well when it comes to laser procedures,” Dr. Lighthizer says.

“We are teaching it well, implementing it well into clinical practice in the 12 states that currently allow laser procedures, and most importantly helping our patients with extremely high levels of care with very few negative outcomes,” he says. “The data is so incredibly strong and compelling.”

It's also highly relevant as state barriers fall—a recent workforce study anticipates a “sizeable shortage” of ophthalmologists to meet patients’ demand for care, which is expected to grow 24%.

With that anticipated shortage, the review underscores the role of doctors of optometry in addressing that demand.

“Filling this gap for eye care services is where optometry could step in, if granted the right to perform advanced procedures,” the review’s authors write.

That demand is why continuing education on laser procedures is now regularly offered at AOA’s Optometry’s Meeting® and through EyeLearn, the AOA’s professional development hub.

“The AOA’s EyeLearn and Optometry’s Meeting courses play a pivotal role in enhancing the safety and effectiveness of laser surgery, as demonstrated by the research,” says Lindsay Wright, O.D., member of the AOA’s Education Center Committee. “By continuously providing eye care professionals with up-to-date knowledge and practical skills through the AOA’s robust course offerings, doctors of optometry are better prepared to handle complex cases and maximize outcomes. This proactive approach to professional development enhances surgical outcomes and promotes overall patient safety, thus underscoring the value of continuous learning.”

Optometry schools and colleges have a major role in preparing optometric students for future scope expansion.

“All faculty at the optometry institutions make it the utmost priority to ensure students are prepared for contemporary optometry by the time they graduate,” says Fraser Horn, O.D., president of the Association of Schools and Colleges of Optometry (ASCO) and dean of Pacific University College of Optometry in Oregon.

“We appreciate the recognition that the schools and colleges of optometry have adjusted their curriculum to include new education and procedures as our profession continues to evolve and advance,” Dr. Horn says.

Good for patients

The biggest beneficiary from expanded scope are patients—especially those needing greater access to care by a trained eye care professional, the authors say.

A previous study indicated that optometrist-performed YAG capsulotomies were effective, safe and convenient to patients who liked the convenience and familiarity of their regular doctor of optometry.

“This is great news for patients because it is going to increase access to high-quality care for them,” Dr. Lighthizer says, referring to the review. “So many patients prefer their local doctors (whether it’s a primary care physician, optometrists or other providers) to provide as much care as possible for them. 

“Patients know their primary eye care doctor (the optometrist) best, and they want them to care for them in the fullest way possible,” he says. “This is another layer of evidence that confirms how well optometry is caring for their patients with laser procedures.”

Johndra McNeely, O.D., chair of the AOA State Government Relations Committee, agrees. The study bears out that optometrists are educated and trained to provide safe, excellent medical eye care including laser procedures, Dr. McNeely says.

“Optometrists in states with laser authority are providing the highest quality care while allowing their patients a greater access to care and choice of providers with very minimal risk,” she says. “All scope advancements in optometry have been a win for patients and will continue to be. They can receive the same care from their current optometric provider in less visits with less wait time.”

AOA resources

Sign up for early registration alerts from Optometry’s Meeting 2025.

Visit EyeLearn to find relevant courses.

Read five considerations if you’re thinking about adding laser procedures to your practice.