Important legislation, A-5445, was recently introduced to address and improve health equity and access to vision and medical eye care for New Jersey’s diverse populations, including our growing, aging population.  

Statewide, and in all geographic settings, New Jersey residents are experiencing unnecessary delays in health care, duplication of services and added medical expenses in part because our state’s optometrists are unable to provide certain minor eye procedures that have been performed more than 100,000 times by optometrists, also recognized as doctors of optometry, in other states. These procedures also have been approved to be performed by optometrists within the U.S. Department of Veterans Affairs. 

Modernizing the scope of practice 

Modernizing New Jersey’s outdated optometric scope of practice will allow optometrists to perform minor, non-invasive, in-office laser eye procedures to treat glaucoma and after-cataract surgery care as well as minor eye care procedures to remove styes and skin tags. These procedures can safely and comfortably be performed using only local or topical anesthesia. Legislation will also expand upon existing vaccination and prescriptive authority for optometrists. 

Optometrists already manage and treat complications that can arise from patients having glaucoma or needing after-cataract care. Under current New Jersey law, if an optometrist determines that a patient needs one of these minor procedures, the patient must be referred to an ophthalmologist for treatment. This extends the time the patient must wait for care and can result in needless duplication of services and additional co-pays, health care costs, travel time and blurry vision. 

Our health care system and workforce are strained, and optometrists can be part of the solution. Ten states currently authorize optometrists to perform these procedures, and more states are working on similar legislative changes. 

Education and training 

Opponents of this legislation question optometrists’ training and skill set to perform these minor procedures.  

Optometrists earn doctorate degrees upon completion of four years of optometry school, which includes extensive classroom, laboratory and clinical training focused on the eye and its components. All U.S. optometry schools train students to perform the procedures included in this legislation, but New Jersey law restricts procedure authority to ophthalmologists and non-eye care advanced practice providers. While part of our job involves fitting patients for glasses and contact lenses, optometrists have also been treating complex eye diseases such as glaucoma for more than 30 years and managing after-cataract conditions for almost 40 years.  

Currently licensed optometrists would not be grandfathered to perform these minor procedures. Rather, they would be required to complete additional training including performing procedures under direct supervision to demonstrate competence to satisfy state board requirements. 

Health equity 

Opponents also suggest there are enough ophthalmologists in New Jersey to treat patients needing this care. 

In reality, there are nearly twice as many optometrists as ophthalmologists in our state. This discrepancy often forces patients to wait a few weeks to a few months to see an ophthalmologist for a procedure that could be performed in-office by an optometrist. One of my colleagues in Jersey City reports there are no ophthalmologists that accept Medicaid in the area, forcing patients, many of whom do not have access to reliable transportation, to travel for care.  

With studies showing there will be 3 million New Jerseyans over age 60 by 2030, an increase of nearly 1 million, there will be an even greater need for these procedures. Adding optometrists, who practice in all areas of the state including urban and underserved communities, to the list of professionals able to provide this care will help fill this gap. Most optometrists also accept Medicaid, which ensures health equity for all citizens.  

The minor eye procedures included in this legislation are low-risk, effective, and can provide immediate results for patients. This legislation is not seeking the right to perform complex surgeries requiring general anesthesia, cutting or injections into the eye.  

Modernizing the scope of practice for New Jersey’s optometrists will align with current optometric education, training and certification and help attract and retain highly skilled, qualified optometrists to live and work in our state. Please ask your legislators for their support to help all New Jerseyans see clearly.