Delaware, also known as “The First State” or “The Diamond State,” is the second-smallest state in the US and covers just under 2,000 square-miles. It
is also the 6th least-populated state in America with just under 1,000,000 total residents. While being one of the more small-scale states, it still offers an abundance of access to the outdoors and natural beauty. Delaware is surrounded by bodies of water on two sides, including the Atlantic Ocean, Delaware River, and the Delaware Bay. These locations offer a large coastline and are home to many beaches. In fact, Delaware has the only coastline which is legally required to be referred to as the “Delaware beaches” as opposed to the “shores” or “coastline”. This offers its residents access to a great deal of outdoor activities, especially involving the water, in the spring and summer.
Delaware is also known to be one of the best states for retirement, as senior citizens are able to enjoy the progressive exclusion of state income taxes towards their retirement from early on. Additionally, Delaware offers reduction of taxes to residents over the age of 65, totaling $2,500 annually. This growing “tax haven” state has an 80% adult population, with one in every four of the residents having some type of systemic health condition that can manifest itself ocularly. This allows for the state to offer a great opportunity for optometrists seeking to practice medical-based optometry.
In Delaware, Optometrists CAN:
• Prescribe and dispense contact lenses and glasses
• Prescribe and dispense vision therapy
• Prescribe oral medications, including Schedules II, III, IV, and V drugs (maximum of 72 hour supply)
• Prescribe oral steroids (maximum of a six-day period)
• Use epinephrine auto-injectors to counteract anaphylaxis
• 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 Delaware, Optometrists CANNOT:
• Administer medications, including anesthetics, by injection, including subcutaneous infiltrative, intralesional, intramuscular, intravenous, and subconjunctival routes
• Perform minor surgical procedures to correct ocular abnormalities, such as removal of “lumps and bumps” around the eye
• 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 cataract extractions, retinal surgery, or refractive surgery (such as LASIK)
• Laser or non-laser injection into the posterior chamber of the eye to treat any macular or retinal disease
• Administer general anesthesia
There is a need for scope expansion within the state as optometrists are restricted with regards to treatment plans they are able to offer their patients. The majority of Delaware’s population resides in one of three metropolitan areas: Wilmington, Dover, and Newark. However, for more rural residents living in Delaware, access to full-scope eyecare from neighboring states can be more beneficial than receiving care within Delaware’s borders. As a result, the Delaware Optometric Association (DOA) and continue working towards scope expansion to allow access to care for all of its state citizens.
There is no recent legislation regarding scope expansion in the state of Delaware. However, the recent House Bill 115 is being voted on in 2019. This bill pushes for the requirement of electronic administration of prescriptions from all healthcare providers.