Optometry

Plain English Breakdown

The effective date for most parts of this law is January 1, 2028.

Optometry Law

This bill updates Tennessee's optometry laws to include certain treatments and procedures for optometrists while setting restrictions on others.

What This Bill Does

• Defines the practice of optometry to include laser-assisted procedures, anterior chamber paracentesis in emergencies, and specific uses of local anesthesia.
• Lists surgical procedures that optometrists are not allowed to perform, such as retina laser procedures or cataract surgery.
• Requires optometrists who use lasers to be certified by the board after completing training from an accredited school.
• Removes a previous exception for using local anesthetics without CPR certification present in the office.

Who It Names or Affects

• Optometrists who practice in Tennessee
• Patients receiving eye care from optometrists

Terms To Know

LASER

A device that uses light to treat medical conditions, often used for precise cutting or removing tissue.

Anterior chamber paracentesis

A procedure where a small hole is made in the eye's front part to reduce pressure inside the eye during an emergency.

Limits and Unknowns

• The bill does not specify all details about how optometrists will be certified for laser use.
• It is unclear what specific training requirements will be set by the board of optometry.

Official Summary Text

The "Optometry Law" provides for the regulation of the practice of optometry in this state, creating the board of optometry ("board") to regulate such profession through rules, regulations, policies, and procedures not inconsistent with such law.

Under such law, the practice of optometry is defined. This bill revises the present law definition to clarify that the practice includes treatment of the eyes, eyelids, and the eye's adnexa and all of the following:



The application of LASER assisted procedures in the diagnosis, management, and treatment of a condition or disease of the anterior segment of the eyelid, eye, or eye's adnexa.



The use of anterior chamber paracentesis in an emergency situation requiring immediate reduction of pressure inside the eye.

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The use of a local anesthetic to treat changes in the eye's adnexa as a result of non-pathological aging.



The use of local anesthesia by injection in performing intramuscular, subcutaneous, and intradermal pharmaceuticals for the aesthetic mitigation of non-pathological aging facial tissue.

Further, this bill clarifies that the practice of optometry generally includes the performance of a surgical procedure for the correction and relief of an ocular abnormality. However, all of the following procedures are prohibited:



Retina laser procedures, laser-assisted in situ keratomileusis (LASIK), and photorefractive keratectomy (PRK).



Non-laser surgery related to removal of the eye from a living human being.

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Non-laser surgery requiring full thickness incision or excision of the cornea or sclera other than paracentesis in an emergency situation requiring immediate reduction of the pressure inside the eye.

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Penetrating keratoplasty, also known as a corneal transplant, or lamellar keratoplasty.

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Non-laser surgery requiring incision of the iris and ciliary body.

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Non-laser surgery requiring incision of the vitreous.

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Non-laser surgery requiring incision of the retina.

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Non-laser surgical extraction of the crystalline lens.

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Incisional or excisional non-laser surgery of the extraocular muscles.

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Non-laser surgery of the eyelid for an eyelid malignancy, for incisional cosmetic, or mechanical repair of blepharochalasis, ptosis, and tarsorrhaphy.

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Non-laser surgery of the bony orbit.

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Incisional or excisional non-laser surgery of the lacrimal system other than punctal dilation, lacrimal probing, lacrimal irrigation, placement of punctal plugs, or other approved therapeutic devices.



Non-laser surgery requiring full thickness conjunctivoplasty with graft or flap.


A laser procedure into the vitreous chamber of the eye to treat vitreous, retinal, or macular disease.



The administration of general anesthesia.



Cataract surgery.

USE OF LOCAL ANESTHETIC

Present law describes the manner in which an optometrist may use a local anesthetic in conjunction with the optometrist's practice. Generally, an optometrist who uses a local anesthetic in such manner must provide to the board proof that the optometrist
has current CPR certification by an organization approved by the board. However, the optometrist may meet this requirement by, instead, providing proof to the board that another person who has current CPR certification will be present in the office of t
he
optometrist at all times that a local anesthetic is used by the optometrist in conjunction with the treatment of an eyelid lesion. This bill removes this exception.

STANDARD OF CARE

This bill provides that an optometrist must be held to the same standard of care as that of other physicians providing similar services.

ON MARCH 12, 2026, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 2076, AS AMENDED.

AMENDMENT #1 clarifies that an optometrist is prohibited from performing the following surgeries, whether or not such surgery is performed by laser:



Surgery related to removal of the eye from a living human being.


Surgery requiring full thickness incision or excision of the cornea or sclera, other than paracentesis in an emergency situation requiring immediate reduction of the pressure inside the eye.


Surgery requiring incision of the iris and ciliary body.


Surgery requiring incision of the vitreous.


Surgery requiring incision of the retina.


Surgical extraction of the crystalline lens.


Incisional or excisional surgery of the extraocular muscles.


Surgery of the eyelid for an eyelid malignancy, for incisional cosmetic, or mechanical repair of blepharochalasis, ptosis, and tarsorrhaphy.


Surgery of the bony orbit.


Incisional or excisional surgery of the lacrimal system other than punctal dilation, lacrimal probing, lacrimal irrigation, placement of punctal plugs, or other approved therapeutic devices.


Surgery requiring full thickness conjunctivoplasty with graft or flap.

This amendment prohibits an optometrist from performing a procedure that requires intravitreal injections.

This amendment requires an optometrist to be certified by the board of optometry ("board") before performing any LASER procedure. In order to obtain such a certification, an optometrist must provide satisfactory proof to the board that the optometrist h
as completed the necessary didactic and clinical training in the use of LASERs from an accredited optometry school or college, including training in the use of LASERs for medically recognized and appropriate treatment of the human eye.

RULEMAKING

This amendment requires the board to adopt rules governing the certification of optometrists to utilize LASERs.

EFFECTIVE DATE

This amendment provides that the bill as amended takes effect on becoming a law for the purpose of
rule promulgation. For all other purposes, the bill as amended takes effect January 1, 2028.

ON MARCH 26, 2026, THE HOUSE SUBSTITUTED SENATE BILL 2076 FOR HOUSE BILL 1952, ADOPTED AMENDMENT #1, AND PASSED SENATE BILL 2076, AS AMENDED.

AMENDMENT #1 incorporates the changes made by Senate Amendment #1 and adds that an optometrist may only perform the following surgical procedures utilizing a LASER:

(1) Peripheral iridotomy;

(2) Selective laser trabeculoplasty; and

(3) YAG capsulotomy.

Current Bill Text

HOUSE BILL 1952
By Williams

SENATE BILL 2076
By Watson
SB2076
011569
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 63,
Chapter 8, relative to optometry.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 63-8-102, is amended by deleting
subdivisions (11) and (12) and substituting:
(11) "Orthoptics" means any ocular exercise for the correction or relief of
abnormal muscles or functions of the eyes;
(12) "Practice of optometry" means:
(A) The employment of an objective or subjective method for the purpose
of ascertaining eye health and a defect of vision, muscular anomaly, or another
abnormal condition of the eyelids, eyes, or the eye's adnexa;
(B) The prescribing of ophthalmic lenses or prisms to remedy or relieve a
defect of vision or muscular anomaly and the prescribing of contact lenses,
including those with prescription power and those without prescription power,
which are worn for cosmetic purposes;
(C) The use of orthoptics and the adjusting, fitting, or adapting of lenses,
prisms, or eyeglasses to remedy or relieve a defect of vision or a muscular
anomaly;
(D) The supplying, replacement, or duplication of an ophthalmic lens or
frame; and
(E) The examination, diagnosis, management, prevention, or treatment
of a condition or disease of the eyelid, eye, or the eye's adnexa, which includes
the following:

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(i) The administration and prescribing of a pharmaceutical agent
rational to the diagnosis and treatment of a condition or disease of the
eyelid, eye, or the eye's adnexa by any route of administration approved
for such use;
(ii) The performance of primary eye care and surgical procedures
rational to the treatment of a condition or disease of the eyelid, eye, or the
eye's adnexa as determined by the board based on an optometrist's
education, training, and experience;
(iii) The performance or ordering of procedures, imaging, and
laboratory tests rational to the diagnosis of a condition or disease of the
eyelid, eye, or eye's adnexa;
(iv) The application of light amplification by stimulated emissions
of radiation (LASER) assisted procedures in the diagnosis, management,
and treatment of a condition or disease of the anterior segment of the
eyelids, eyes, or eye's adnexa;
(v) The administration of diphenhydramine, epinephrine, or an
equivalent medication to counteract anaphylaxis or anaphylactic reaction
and the use of anterior chamber paracentesis in an emergency situation
requiring immediate reduction of the pressure inside the eye;
(vi)
(a) The use of a local anesthetic in conjunction with the
primary care or surgical treatment of an eyelid lesion or changes
in the eye's adnexa as a result of non-pathological aging.
However, an optometrist shall not use a local anesthetic for such
purposes unless the optometrist has met the certification

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requirements as described in § 63-8-112(4) and in the rules
adopted by board for the administration of a pharmaceutical agent
in the performance of primary eye care and a surgical procedure;
and
(b) Utilizing local anesthesia by injection in performing the
following procedures:
(1) Needle drainage of an eyelid abscess,
hematoma, bulla, and seroma;
(2) Excision of a single epidermal lesion without
characteristics of malignancy, no larger than five
millimeters (5 mm) in size and no deeper than the dermal
layer of the skin;
(3) Incision and curettage of a nonrecurrent
chalazion;
(4) Simple repair of an eyelid laceration no larger
than two and one-half centimeters (2.5 cm) and no deeper
than the orbicularis muscle and not involving the eyelid
margin or lacrimal drainage structures;
(5) Removal of a foreign body in the eyelid not
involving lid margin, lacrimal drainage structures, and
extending no deeper than the orbicularis muscle; and
(6) Intramuscular, subcutaneous, and intradermal
pharmaceuticals for the aesthetic mitigation of non-
pathological aging facial tissue; and

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(vii) As approved by the board, the performance of a surgical
procedure for the correction and relief of an ocular abnormality, except for
the following procedures:
(a) Retina laser procedures, laser-assisted in situ
keratomileusis (LASIK), and photorefractive keratectomy (PRK);
(b) Non-laser surgery related to removal of the eye from a
living human being;
(c) Non-laser surgery requiring full thickness incision or
excision of the cornea or sclera other than paracentesis in an
emergency situation requiring immediate reduction of the pressure
inside the eye;
(d) Penetrating keratoplasty, also known as a corneal
transplant, or lamellar keratoplasty;
(e) Non-laser surgery requiring incision of the iris and
ciliary body;
(f) Non-laser surgery requiring incision of the vitreous;
(g) Non-laser surgery requiring incision of the retina;
(h) Non-laser surgical extraction of the crystalline lens;
(i) Incisional or excisional non-laser surgery of the
extraocular muscles;
(j) Non-laser surgery of the eyelid for an eyelid
malignancy, for incisional cosmetic, or mechanical repair of
blepharochalasis, ptosis, and tarsorrhaphy;
(k) Non-laser surgery of the bony orbit;

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(l) Incisional or excisional non-laser surgery of the lacrimal
system other than punctal dilation, lacrimal probing, lacrimal
irrigation, placement of punctal plugs, or other approved
therapeutic devices;
(m) Non-laser surgery requiring full thickness
conjunctivoplasty with graft or flap;
(n) A laser procedure into the vitreous chamber of the eye
to treat vitreous, retinal, or macular disease;
(o) The administration of general anesthesia; and
(p) Cataract surgery;
SECTION 2. Tennessee Code Annotated, Title 63, Chapter 8, Part 1, is amended by
adding the following as a new section:
An optometrist who uses a local anesthetic, as described in § 63-8-
102(12)(E)(vi), shall provide to the board proof of the following:
(1) The optometrist has a current cardiopulmonary resuscitation (CPR)
certification by an organization approved by the board; and
(2) The optometrist has an automated external defibrillator (AED) present
at all times in the optometrist's office in which the optometrist is administering the
local anesthetic.
SECTION 3. Tennessee Code Annotated, Title 63, Chapter 8, Part 1, is amended by
adding the following as a new section:
An optometrist must be held to the same standard of care as that of other
physicians providing similar services.
SECTION 4. This act takes effect upon becoming a law, the public welfare requiring it.