Clinical Report: Time to Prepare to Offer In-Office Laser Care?

Overview

In-office laser procedures, such as YAG capsulotomy and selective laser trabeculoplasty, are gaining traction among optometrists, with a significant reduction in negative outcomes reported. The increasing demand for age-related eye disease interventions, particularly in rural areas, underscores the need for optometrists to expand their scope of practice to include these procedures.

Background

The aging population in the United States is projected to increase significantly, leading to a higher prevalence of age-related eye diseases such as cataracts and glaucoma. With a projected shortage of ophthalmologists by 2035, optometrists are positioned to fill this gap by offering in-office laser procedures. Recent studies indicate that these procedures have a high success rate and can serve as a new revenue stream for practices.

Data Highlights

No numerical data available.

Key Findings

• Out of 146,403 laser procedures performed by optometrists, only 2 had negative outcomes.
• 8 of the 14 state scope-of-practice expansion laws enabling optometrists to perform laser procedures were passed between 2019 and 2025.
• 13 states introduced or reintroduced bills for optometric laser procedure access in 2025.
• Approximately 9.7 million Americans aged 65 and older live in rural areas, often requiring eye disease interventions.
• The US ophthalmology workforce is projected to face a significant shortage by 2035.

Clinical Implications

Optometrists should consider preparing their practices to offer in-office laser procedures to meet the growing demand for eye care, especially in underserved rural areas. Training and legislative support are crucial for expanding the scope of practice and improving patient access to necessary interventions.

Conclusion

The outlook for in-office laser procedures is promising, with strong evidence supporting their effectiveness and a clear need for expanded optometric services in the face of an aging population.

References

1. Lighthizer N, Patel K, Cockrell D, et al., Clin Exp Optom, 2025 -- Establishment and review of educational programs to train optometrists in laser procedures and injections
2. Ahmed A, Ali M, Dun C, et al., JAMA Ophthalmol, 2025 -- Geographic distribution of US ophthalmic surgical subspecialists
3. Berkowitz ST, Finn AP, Parikh R, et al., Ophthalmology, 2024 -- Ophthalmology workforce projections in the United States, 2020 to 2035
4. Optometric Management — Preparing to Offer In-Office Laser Procedures
5. optometric management — Preparing to Offer In-Office Laser Procedures
6. Contact Lens Spectrum — Prepare Yourself to Comanage LASIK Patients
7. Ophthalmology Management — Viewpoint
8. Preparing to Offer In-Office Laser Procedures
9. Update information | Glaucoma: diagnosis and management | Guidance | NICE
10. Primary Angle-Closure Disease Preferred Practice Pattern® - PubMed
11. YAG Laser Capsulotomy (Posterior Capsulotomy): Procedure