Bill
HB 2897
Missouri HB2897 expands optometry to include injectable medications and select eye-related procedures, with a 32-hour board-certified training requirement for injections/laser use.
HB 2897 (Missouri, 2026) — Summary
Overview
- Purpose: Expand the scope of the practice of optometry to include injectable pharmacologic agents and certain surgical procedures, subject to board rules and a 32-hour certification for injections/lasers. The bill also adds several specific procedures to optometry’s scope, with limited exceptions for very invasive or high-risk surgeries.
Key Provisions
1) Definition and scope of optometry (Section 336.010)
- The practice of optometry is defined as examination, diagnosis, prevention, and treatment of the eye, adnexa, and vision, including surgical or nonsurgical treatment.
- Adds explicit authorization for:
- Prescription and administration of pharmaceutical agents (therapeutic agents and diagnostic/therapeutic drugs) for eye conditions (previously excluded injectable agents).
- A broad set of procedures (see below) now within the optometrist’s scope.
- Enumerates specific procedures now allowed, including:
- Removal of superficial foreign bodies from the eye or adnexa.
- Removal of nonperforating foreign bodies from the cornea, conjunctiva, or eyelids.
- Removal of eyelashes.
- Scraping of the cornea for diagnostic tests, smears, or cultures.
- Dilation, probing, irrigation, or closure of the tear drainage structure.
- Expression of conjunctival follicles or cysts.
- Debridement of the corneal epithelium.
- Incision and curettage of a chalazion.
- Removal and biopsy of skin lesions without known malignancy.
- Laser capsulotomy; laser trabeculoplasty; laser peripheral iridotomy.
- And additional procedures within the optometrist’s education/training scope as allowed by board rules (non-listed procedures that fall under the scope).
- Terminology definitions included for eyes, adnexa, board, diagnostic/therapeutic/pharmaceutical agents, low vision care, and vision therapy.
2) Restrictions and exclusions on surgical scope (Section 336.010(2))
- The bill retains a list of procedures not within optometry’s scope and not to be performed by optometrists, including:
- Retina laser procedures (e.g., LASIK, PRK) and related surgical care are excluded except for preoperative and postoperative care.
- Major intraocular/ocular surgeries and implants, penetrating keratoplasty, scleral incisions, vitreous/retina incisions, intraocular lens extractions/implantations, and related nonlaser surgeries.
- Eyelid malignancy surgeries and certain cosmetic/repair surgeries, unless specifically within the new optometric scope.
- Any nonlaser surgery that does not address ocular abnormalities, and any laser/nonlaser injections into the posterior chamber for macular/retinal disease.
- Administration of general anesthesia.
3) Certification requirement for injections/laser procedures (336.023)
- New certification pathway: An optometrist must complete a 32-hour certification program (didactic plus clinical/lab) approved by the board and offered by a college/school of optometry to administer or perform injections or laser procedures listed in subdivisions (6)–(16) of subsection 1 (which include several diagnostic/treatment and laser procedures).
- Exemption for recent graduates: Optometrists who graduated from an accredited optometry program after July 1, 2020, are exempt from these certification requirements.
4) Definitions (Section 336.010(3))
- Clarifies terms such as “eye,” “adnexa,” “diagnostic pharmaceutical agents,” “pharmaceutical agents,” “therapeutic pharmaceutical agents” (recognizing injectable agents as included), “low vision care,” and “vision therapy.”
Impacts and Stakeholders
- Affected professionals: Licensed optometrists in Missouri would gain authority to administer injectable pharmacologic agents and perform selected surgical/laser procedures, subject to board-approved training.
- Training and credentialing: Practitioners would need the 32-hour board-approved certification to perform injections/laser procedures not previously allowed; newer graduates have an exemption, reducing barriers for recent grads.
- Patients: Potentially increased access to in-office treatments and procedures for eye conditions that previously required physician specialists or hospital-based settings.
- Medical community: Some ophthalmology and ophthalmic surgical groups may raise concerns about scope of practice and training for complex surgical procedures; the bill addresses this with explicit restrictions for high-risk surgeries and a structured training requirement.
Procedural/Timeline Notes
- The bill references a 32-hour certification process and board-approved education; specifics would be set by the Missouri Board of Optometry through future rulemaking.
- Fiscal notes indicate no net state revenue impact and no change in general fund expenditures in the short term; small business impact may occur for optometrists adapting to expanded scope and training.
Status
- Reported Do Pass by the House Professional Registration and Licensing Committee with a pair of co-sponsors (Farnan, Griffith).
- Timeline considerations follow usual legislative process for potential passage and implementation with board-rule updates.
Compiled from official sources — confirm details with the bill’s official record.
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