relative to the practice of optometry and authorization to perform ophthalmic laser procedures.
Summary
HB 349 expands the scope of practice for licensed optometrists by allowing them, once certified by the Board of Registration in Optometry, to perform three specified ophthalmic laser procedures: laser capsulotomy, laser trabeculoplasty, and laser peripheral iridotomy. The bill does not automatically authorize all optometrists to do these procedures; instead, it requires board certification based on rules the board must adopt for education, training, live clinical experience, proctoring, outcome reporting, and verification of certified providers.
To qualify, an optometrist must complete a board-approved laser course, demonstrate clinical proficiency under a board-approved proctor, and document minimum numbers of supervised procedures. The bill also creates a pathway for certification by endorsement for optometrists already authorized in another state, provided they meet New Hampshire’s training and proficiency requirements. It further requires informed consent before any procedure and makes the consent part of the patient’s medical record. The act takes effect 60 days after passage.
Impact
The bill amends RSA 327 by adding a new section authorizing certified optometrists to perform certain ophthalmic laser procedures and directing the Board of Registration in Optometry to establish the certification standards and oversight rules. It affects optometrists, ophthalmologists, patients receiving eye care, and the Office of Professional Licensure and Certification, which may incur administrative costs and potentially collect additional fee revenue. The fiscal note indicates no appropriations are provided and that state costs and revenues are indeterminable but could increase after FY 2026.
Sentiment
The voting history suggests the bill was controversial and did not command broad consensus. It initially survived a motion to table and a motion to indefinitely postpone, and the House later adopted the bill, but the final veto-override vote failed. That pattern indicates substantial support for expanding optometric practice authority, alongside significant opposition strong enough to block final enactment.
Contention
The main point of contention is whether optometrists should be permitted to perform ophthalmic laser procedures that have traditionally been associated with ophthalmologists. Supporters appear to favor expanding access and modernizing scope-of-practice rules, while opponents likely raised concerns about patient safety, training adequacy, and whether optometrists should be allowed to perform invasive eye procedures. The bill attempts to address those concerns through strict certification, proctoring, and informed-consent requirements, but the divided votes show that those safeguards were not enough to resolve the dispute.