New Jersey is at a critical crossroads in health care. Despite being home to world-class health care institutions, the state’s outdated regulations prevent optometrists from offering modern, life-enhancing laser eye procedures.
New Jersey’s legislators are currently considering A-920/S-354, which will modernize the state’s outdated optometric scope of practice regulations and improve access to care and health equity in the Garden State. This legislation will allow optometrists to perform specific non-invasive, in-office, minor laser procedures to treat glaucoma, provide after-cataract surgery care and complete minor eyelid procedures to remove styes and skin tags.
As a practicing optometrist and dean of a major college of optometry, I have completed thousands of laser eye procedures on my patients over the last 15 years. I have co-authored two textbooks, which are viewed as the “gold standard” in the optometry and ophthalmology fields, and have trained thousands of optometry students and practicing optometrists to perform the procedures. Yet even with this experience, if I moved to New Jersey, I wouldn’t be able to provide these laser services to my patients.
Optometrists in 12 other states are authorized to perform these procedures, and many new optometrists are choosing to move to those states after graduation so they can practice to the full extent of their education and training. In fact, Oklahoma’s optometrists have safely been completing laser procedures for 36 years. Optometrists in Kentucky and Louisiana have a more than 10-year proven track record.
Earlier this year, I published the results of a study that reviewed the safety and effectiveness of laser procedures performed by optometrists in 12 states since 1988. Out of the more than 140,000 procedures, 0.001% had complications. This remarkable safety record can be attributed to the extensive didactic and hands-on training provided by all U.S. optometry schools, which continually adjust and evolve their curriculum to include the latest procedures and technologies. But learning doesn’t stop in school. After graduation, practicing optometrists, like all health care professionals, learn new skills and build upon their training through continuing education courses.
There are additional studies to support optometric scope expansion. I co-authored a 2023 study, which found that 99% of patients reported improved vision after an optometrist-performed capsulotomy, one of the laser procedures included in this year’s legislation. A 2022 ophthalmology study showed that selective laser trabeculoplasty, another procedure in this legislation, provided better long-term treatment for glaucoma than eye drops.
More than 3 million Americans have glaucoma, a number that is expected to double by 2050 as the population ages. Currently optometrists in New Jersey can only prescribe medications to treat patients with glaucoma even though laser procedures have been proven to be more effective. If one of these procedures is recommended, the patient must then schedule an additional appointment with an ophthalmologist regardless of their optometrist’s training. Optometrists already manage the follow-up care associated with these procedures, and we have the medical judgment to know when to consult with or refer patients to other specialists. Shouldn’t we also have the ability to offer the best treatment option to our patients?
As New Jersey’s population ages, the demand for laser procedures will rise, often faster than the number of practicing ophthalmologists. A recent workforce study published in the Journal of Ophthalmology anticipates a 24% increase in demand for these procedures while the number of ophthalmologists is expected to decline 12% by 2035 in the U.S.
Fifty years ago, optometrists were not permitted to dilate a patient’s eyes or prescribe therapeutic drops or oral pharmaceuticals. Can you imagine not being able to receive these services from your optometrist today? The same should be said for certain laser procedures.
A-920/S-354 is about authorizing highly qualified and trained doctors to perform procedures they are trained to do. It’s about having a larger pool of providers to deliver care safely and effectively. It’s about encouraging young professionals to move to your state and about positioning New Jersey as a leader in offering this care to all citizens. Please ask your legislators to support A-920/S-354.
Nate Lighthizer, OD, FAAO, FAAOMS, is a professor and serves as dean of Northeastern State University Oklahoma College of Optometry.
