Kentucky Optometry: An Expanded Scope of Practice

Beautiful evening scene in rural Kentucky

Known as the Bluegrass State, Kentucky is famous for its beautiful horses and bourbon. Unfortunately, it is also a region plagued with the highest rate of vision loss due to secondary factors such as diabetes and hypertension. The Centers for Disease Control and Prevention reported on the U.S. counties with the highest prevalence of severe vision loss, the majority of which were located in the south. Overall, about three percent of people had severe vision loss. The highest rate amongst all American regions was Owsley County, located in the coalfields of Eastern Kentucky, at more than 18 percent.

Thanks to the hard work of the Kentucky Optometric Association (KOA) and the American Optometric Association (AOA), Kentucky has an expanded scope of practice for optometrists. In order to provide the citizens of Kentucky with increased access to eye and vision care services, the Better Access to Quality Eye Care Bill was signed into law in 2011 (read about it here). Kentucky became the second state, after Oklahoma, to allow optometrists, who are properly credentialed, privileges to practice at a higher scope. The expanded scope of practice permitted by Kentucky state law governing the practice of optometry provides for selective laser and periocular surgical procedures, which provides increased access to the latest eye care technologies for many Kentuckians. The Kentucky College of Optometry (KYCO) students will also provide services in area health clinics, which means an increased number of Kentuckians in underserved areas will receive services.

In Kentucky, optometrists CAN:

  • Administer medications, including anesthetics, by injection, including subcutaneous infiltrative, intralesional, intramuscular, intravenous, and subconjunctival routes
  • Perform anterior segment laser procedures including YAG capsulotomy used to treat cloudy lens implants following cataract surgery, Selective Laser Trabeculoplasty (SLT) and Laser Peripheral Iridotomy (LPI) used to treat some forms of glaucoma
  • Perform minor surgical procedures to correct ocular abnormalities, such as removal of “lumps and bumps” around the eye
  • Prescribe oral medications, including Schedules II (hydrocodone-combination products), III, IV, and V drugs
  • Prescribe oral steroids
  • Diagnose and treat glaucoma with topical and oral drugs
  • Co-manage post-op care
  • Perform procedures such as foreign body removal, dilation and irrigation, punctal occlusion, and eyelash epilation

In Kentucky, optometrists CANNOT:

  • Perform cataract extractions, retinal surgery, or refractive surgery (such as Lasik)
  • Laser or nonlaser injection into the posterior chamber of the eye to treat any macular or retinal disease
  • Administer general anesthesia

With the field of optometry constantly evolving, it should come as no surprise that the role optometrists perform in the delivery of primary eye care is changing right along with it. Optometry is a legislated profession, and that means it is important for all current and future optometrists to stay involved in their state and national organizations to make sure optometry moves forward. Hopefully, in the future all states will enjoy an expanded scope of practice; for now, Kentucky is one of the leaders in the field. 

If you are planning on practicing in Kentucky, support the KOA today! Attend the 115th Annual KOA Spring Congress, which will be held April 27-29, 2017 in Lexington, KY. Additionally, the KOA has a number of networking opportunities and resources to help provide you with guidance as you start your profession.

For more articles about the optometric scope of practice in other states, click here!

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