Optometry – Expanding the Scope of Practice in Vermont

Eye care specialists generally fall into one of two categories: optometrists and ophthalmologists. The primary difference between the two is in their scope of practice and the education required to achieve each position.

Ophthalmologists are medical doctors who, like optometrists, diagnose and treat a wide range of eye conditions. Ophthalmologists can also perform eye surgery and prescribe medication.

Optometrists on the other hand, are not medical doctors, but like ophthalmologists, optometrists perform comprehensive eye exams, diagnose and treat a similarly wide range of eye conditions, and prescribe eyeglasses and contact lenses. They do not perform surgery or prescribe medications.

To round out the eye care team there are also ophthalmic nurses who specialize in providing required nursing care for patients with eye conditions and diseases, and there are opticians who are technicians that design, fit, and adjust eyeglasses, frames, and contact lenses.

Optometry and Ophthalmology Education

Anyone going into a medical related field generally starts out on a pre-med track while pursuing an undergraduate degree. With that degree in hand, future optometrists enroll in an additional four-year graduate program culminating in a Doctorate of Optometry (DO).

An optometrist’s four-year education is focused on primary eye care including anatomy, physiology, pharmacology, histology, biochemistry, optics, neuroanatomy, pathology, research, disease diagnosis and management and pre- and post-operative care.

Ophthalmologists enroll in four years of medical school, followed by at least three years of ophthalmology residency specializing in surgical procedures and advanced medical care for eye diseases.

Expanding the Scope of Optometry in Vermont

Every state has some mechanism to oversee and administer laws, licensing, and best practices in most medical professions.

In Vermont, there is a five-member Board of Optometry that was created by the legislature. Members are appointed by the governor and are charged with “ensuring applicants are qualified for licensure; setting standards for the profession by proposing statutes and adopting administrative rules; and, with the assistance of Office of Professional Regulation staff, investigating complaints of unprofessional conduct, taking disciplinary action against licensees when necessary to protect the public.”¹

Senate bill S.64, and its companion bill H.241 in the Vermont House, currently making its way through the Vermont Legislature is proposed to “revise and further define the scope of practice for optometrists. It would also create an advanced therapeutic procedures specialty that would allow qualified optometrists to perform certain advanced therapeutic procedures.”²

The bill as written seeks to expand the current scope of practice for optometrists in Vermont to include laser surgery for post-cataract haze, prevention of glaucoma, and early glaucoma treatment, as well as the surgical removal of small lid lumps and bumps by drainage or excision, therapeutic injections for local anesthesia, and treat keratoconus with corneal cross-linking, a procedure that uses eye drops and UVA light to strengthen the cornea.³

Opposition to the bill appears focused primarily on maintaining the status quo where any procedure remotely “surgical” in nature remains solely the scope of ophthalmologists. There are currently twelve states that allow optometrists to practice at the level recommended in the bill.

For more information on the bill and the work of optometrists in Vermont, visit the Vermont Optometric Association online.

Premier Optometry at Optical Expressions

^{1https://governor.vermont.gov/boards_and_commissions/optometry#:~:text=Description%3A%20The%20Board%20of%20Optometry,in%20the%20state%20of%20Vermont.}

^{2 https://legislature.vermont.gov/Documents/2026/Docs/BILLS/S-0064/S-0064%20As%20Introduced.pdf}

^{3 https://vtoptometrists.org/scope/?utm_source=Vermont+Public&utm_campaign=579a463036-capitol-recap&utm_medium=email&utm_term=0_-579a463036-588815877&mc_cid=579a463036}