Envisioning expanding access to eye care

Across the country, patients are struggling to access health care services — particularly those in rural areas, where driving long distances to see a specialist has become increasingly common. One area of acute shortage is eye care, where demand for services is rapidly outpacing the supply of ophthalmologists.

Meanwhile, a large, highly trained workforce of optometrists remains sidelined by laws that prevent them from performing routine and medically necessary procedures.

More than a dozen states permit optometrists to perform what is known as a YAG laser capsulotomy — a simple, in-office procedure to treat “secondary cataracts,” a condition that often develops after cataract surgery and causes cloudy vision. Over half a million elderly Americans receive this procedure each year, and its safety record is excellent. Yet in most states, only ophthalmologists are allowed to perform them.

Restricting optometrists’ scope of practice comes at a real cost to patients. In 2020, the U.S. had about three times more optometrists than ophthalmologists. And while ophthalmologists tend to be concentrated in urban centers, more than 99 percent of Americans live in a county with a practicing optometrist. As a result, patients needing a YAG procedure often face long wait times and high travel costs to be seen by an ophthalmologist.

We understand concerns about patient safety. No one wants to allow unqualified providers to perform dangerous procedures. In this case, there is little cause for alarm. Optometrists complete four years of doctoral training in eye care in the U.S.,........

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