Washington State Bill Would Pave Way for Optometrists to Perform Surgery

There is an interesting discussion going on in the Washington state legislature.

The Evergreen State is debating whether optometrists should be allowed to conduct an expanded range of services, including the ability to perform certain eye surgeries.

Granted. This isn’t an altogether “new” discussion. Expanding the roll of optometrists has been talked about – and in some cases hotly contested – for decades.

Optometrists only earned drug-prescribing privileges in the mid 1980s after overcoming heated opposition from ophthalmologist groups. There was a similar debate a few years later when those drug-prescribing privileges expanded from topical drugs, such as eyedrops and creams, to oral medications. (For instance, Florida became the 47th state to make this change just a decade ago.)

The discussion now has turned to surgical procedures.

Currently, nine states allow optometrists to perform some minor surgeries, including five which allow them to do laser treatments. Washington state senate bill 5389 would, among other things, allow optometrists to use lasers during exams or for treatments, and let them remove objects from eyes.


However, just last year California Gov. Gavin Newsom vetoed a bill that would have allowed optometrists to perform “advanced surgical procedures.” The American Medical Association was fervently opposed to the bill, framing it as a “radical” step.

According to a story on its website, “the AMA has helped defeat multiple bills that would have expanded the scope of optometrists, including a similar bill in Alabama, as well as legislation in Utah and Washington that would have allowed optometrists to perform eye surgery and increase their prescriptive authority.”

The AMA, along with the Washington State Medical Association, is opposed to the proposed bill in the state of Washington.

According to an article in The Columbian, Dr. Courtney Francis, president of the Washington Academy of Eye Physicians and Surgeons, shared her concerns before the Senate Health and Long Term Care committee during a public hearing earlier this week.

“To be clear, optometrists are not equivalent to ophthalmologists and are simply not trained to diagnose and manage complex eye disease, including the indications for performing and managing the complications of the surgeries they are requesting,” said Dr. Francis.

Washington state Sen. Annette Cleveland, D-Vancouver, sponsored the bill and chairs the committee. She cited patient access to treatment as a driving force behind the bill.


“Patients in my district often share with me their concerns about eye care needs that they have and that they’re forced to drive across the river to another state to address,” she said, according to The Columbian.

Vancouver, Washington, it should be noted, sits across the Columbia River from Oregon, one of the states which allows optometrists to perform minor surgical procedures.

A pair of doctors were among those who voiced support for the bill. One suggested that optometry schools across the country are providing the necessary levels of education to facilitate the proposed expansion of duties. The other suggested that rural residents would benefit greatly with expanded access to necessary treatments.

Watch the entirety of the public comments for and against the bill in the video below.