Washington State Optometry Scope of Practice & Legislation

Thanks to UCBSO AOSA Trustee Alex Chow for writing this article as part of our Legislative Series!

For years the Optometric Physicians of Washington (OPW) has worked continuously and tirelessly to protect and expand the optometric scope of practice in Washington State. The resulting scope of practice is outlined by RCW 18.53.010Considering practicing optometry in the Evergreen State? Read below for the current scope of practice, laws and ongoing legislation:

What CAN we do?

  • Prescribe Schedule II (hydrocodone products only), III, IV, and V controlled substances and any oral legend drugs, except oral corticosteroids.
  • Prescribe nonscheduled oral antibiotics, antivirals, antifungals, antihistamines, decongestants, dry eye agents, anti-emetics, and diuretics.
  • Diagnose and provide glaucoma treatment with any topical medication as well as oral carbonic anhydrase inhibitors or osmotic diuretics.
  • Remove superficial foreign bodies, epilate misaligned lashes, insert punctal plugs, and perform diagnostic dilation and irrigation of the lacrimal system.
  • Use diagnostic instruments utilizing laser or ultrasound technology and order radiologic or laboratory testing necessary to diagnose eye-related disease.
  • Order diagnostic testing.
  • Perform injections for anaphylaxis.

What CAN’T we do?

  • Prescribe Schedule I or II controlled substances (except for hydrocodone products).
  • Administer injections or infusions other than epinephrine for anaphylactic shock.
  • Perform ophthalmic surgery, which is defined as any invasive procedure in which human tissue is cut, ablated, or penetrated by incision, injection, laser, ultrasound, or other means in order to treat human eye disease, alter refractive error, or enhance cosmetic appearance.

Goals of the Optometric Physicians of Washington

  • Minimize insurance discrimination against optometrists.
  • Protect patients against disruptive technologies and other entities that aim to provide optometric care without proper training.

Protect YOUR Profession!

“It takes years of diligent work educating legislators and getting the legislation in place to benefit the public and the profession. It is not easy to pass legislation; there are many, many opposing interests.” -Dr. Michael Heil, OD, OPW President Elect


OPW needs your support and participation in order to continue its great work. Only by working together can we ensure the continuation of a strong profession. Take matters into your own hands and become involved as an OPW student member! Student membership is free, and applications can be found at http://washington.aoa.org/ (note that AOSA membership is a requirement for OPW student membership). Questions regarding OPW can be directed to Executive Director Judy Balzer at opw@eyes.org.

Check out other articles in our optometry legislative series hereHere is an infographic showing the scope of practice in all 50 states.

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