What’s the context?

Lawmakers added provisions to address the confusion created by a previous DEA mandate requiring specific coursework for any clinician with a DEA registration. Because some state-developed CE courses did not meet federal standards, ODs practicing in those states faced the possibility of completing two versions of essentially the same training (one state, one federal). This new law allows the AOA to review and certify state-developed courses so they meet federal expectations, removing the risk of redundant requirements for optometrists.

AOA President Jacquie M. Bowen, OD, said the update strengthens support for the profession. “This legislative win is a meaningful step forward for patient care and for the doctors of optometry who serve communities every day,” she said.

In their announcement, the AOA notes that to meet the DEA’s current eight-hour education requirement, doctors can continue to use the Providers Clinical Support System (PCSS) “Substance Use Disorder 101 Core Curriculum” (developed by the American Academy of Addiction Psychiatry). The 23-module program offers an overview of evidence-based approaches to substance use disorders and co-occurring conditions. Modules are free with registration, and the AOA advises ODs to select “other” and specify optometry when prompted for their profession.

The AOA is also preparing an optometry-specific course that will be available in the coming months. An in-person education offering will follow at Optometry’s Meeting 2026 (June 17 – 20 in Phoenix).

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AOA leaders say NAVCP has circulated inaccurate materials in Washington, D.C., including claims that optometrists impose excessive markups on frames and lenses and suggestions that pending bills would disrupt continuity of care. NAVCP has gone further, disparaging optometrists publicly by characterizing them as “salespeople.”

Strong statements have come from AOA leadership in response:

“It is telling — but not surprising — that NAVCP and VBMs at large are opposing us as they are,” says AOA President Jacquie M. Bowen, OD. “Their reliance on scare tactics and misinformation is designed to mask the truth: Their business models depend on restricting doctor choice, suppressing competition, and prioritizing profits over patients. No matter the other side’s vast resources or apparent eagerness to denigrate the integrity of our profession, our AOA will never allow the VBMs to have the last word on Capitol Hill, with the media, or with the public.”

At the center of the clash are two bills now before Congress: the Vision Lab Choice Act (S. 1716) and the Dental and Optometric Care Access Act (H.R. 1521). These measures would prevent VBMs from steering doctors to labs or suppliers they own or control and would protect optometrists from restrictive contract terms that limit professional judgment and patient choice. Advocates argue that the reforms would curb anti-competitive behavior, protect patient access, and preserve doctors’ ability to provide care based on clinical, not corporate, priorities.

The VBM lobby has fought hard against these proposals, including mounting legal challenges to state-level reforms such as Texas’ 2023 law regulating vision benefit plans. While NAVCP recently agreed to retract some materials after AOA fact-checking revealed errors, the group has not committed to changing its lobbying tactics or hostile rhetoric, which optometry advocates say reflect a broader pattern of misinformation and antagonism.

What’s at stake

• If the Vision Lab Choice Act advances, ODs could decide where to send lab work without being forced into VBM-owned facilities.
• The DOC Access Act would limit take-it-or-leave-it contracts that lock doctors into unfavorable terms. Expect clearer, more equitable agreements if these reforms succeed.
• These bills aim to restore clinical decision-making to the exam room, cutting back on the influence of corporate entities that prioritize profit margins over patient care.

Estimated timeline

Both bills are currently at the same stage. Here’s a rough, best-case scenario timeline, assuming things go relatively smoothly:

Late 2025: Committees hold hearings, possibly markups, especially following AOA advocacy around AOA on Capitol Hill.
Early 2026: Bills reported out of committees, floor votes in one or both chambers.
Mid-2026: If both pass, negotiations (if needed), then final passage.
Late 2026: Implementation and oversight could begin. If Congress delays action, however, the bills risk stalling out well before then.

The future of these reforms depends on continued advocacy from within the profession. ODs and students can:

• Participate in AOA on Capitol Hill (September 28, 2025) to meet with lawmakers directly.
• Contact your senators and representatives to voice support for the Vision Lab Choice Act and DOC Access Act.
• Share your experiences with restrictive plan practices to help illustrate why these reforms matter.

Sample script for contacting reps

Find contact information for your representatives here:

House: https://www.house.gov/representatives/find-your-representative
Senate: https://www.senate.gov/senators/senators-contact.htm

Subject: Please Support the Vision Lab Choice Act (S. 1716) and DOC Access Act (H.R. 1521)

Dear [Senator/Representative],

My name is [Your Name], and I am an optometrist/student practicing in [City, State]. I am writing to ask for your support of the Vision Lab Choice Act (S. 1716) and the Dental and Optometric Care Access Act (H.R. 1521).

These bills are critical to protecting patients’ access to quality eye care. Current practices by vision benefit managers often force doctors into restrictive contracts and limit the labs or suppliers we can use, which drives up costs and undermines the doctor-patient relationship.

In my own experience, these rules make it harder to put patients’ needs first. Supporting these bills will ensure that our decisions in the exam room are guided by clinical expertise, not corporate mandates.

I urge you to co-sponsor and support these reforms to promote fair, transparent, patient-centered care.

Thank you for your time and consideration.

Sincerely,
[Your Name]
[Your Practice/School]
[City, State]

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“This latest revision of the AOA’s Telemedicine in Optometry policy reflects both the input of our members and the rapid pace of change in telemedicine,” said AOA trustee Marrie S. Read, OD, MBA, noting that since the last update in 2022, optometry has seen “real-time patient connections, remote monitoring of chronic conditions, and new platforms that support care.”

What does it say?

The new policy sharpens definitions of terms such as synchronous and asynchronous care, direct-to-patient applications, and standard of care. It also reinforces that mobile vision apps cannot replace a comprehensive in-person eye exam and that prescriptions for glasses or contact lenses must come from a full clinical evaluation. It further outlines expectations for documentation, privacy protections, licensure compliance, and ongoing training for practices adopting telehealth.

Sections in the policy include:

• Key terminology
• Criteria for high quality telemedicine in optometry
• Organization, training, and implementation
• The doctor-patient relationship and the use of direct-to-patient technology
• Use cases for telemedicine in optometry
• Administrative and legal Considerations

One notable point: AI has been separated from the telemedicine policy, with AOA acknowledging that AI’s impact reaches far beyond telehealth. A dedicated review of AI in optometry is already underway.

A closer look

Beyond the broad updates, here a few details worth your attention:

• The statement reminds us that “standard of care” isn’t a clinical term but a legal one, defined differently across states. That means telehealth liability depends as much on legislation and courts as on professional norms.
• The policy calls for stronger guardrails on patient-facing tech, warning that fragmenting a comprehensive exam into stand-alone screenings is “deleterious and deceptive to patients.” That language signals a harder line against consumer apps marketed as eye exams.
• Organizations should maintain documented proof of staff competency in telehealth delivery, since it is to be held to the same standards as in-person care.
• The disclaimer section highlights that if ODs deliver direct telehealth services, they bear full responsibility for the patient’s care. In consultative models, liability may be shared. That distinction matters for practices exploring cross-state or collaborative setups.
• By moving AI into its own policy track, the AOA is setting the stage for a separate, likely more robust set of guardrails. Keep watch for how AI will be regulated not just in telehealth but across clinical practice.

Overall, the statement embraces telemedicine as a valuable tool for expanding access and improving care coordination, but it makes clear that the comprehensive eye exam remains the criterion standard.

Read the full Policy Statement on Telemedicine in Optometry.

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Tariffs are the top story everywhere, and the optical industry is not immune. Uncertainties about the practical impact of the tariffs abound, so let’s break down what’s going on:

President Trump announced “reciprocal” tariffs on April 2, 2025, slapping a 10% blanket duty on nearly all imports, with certain countries, like China, facing even steeper increases.

Reciprocal tariffs means that if a country has higher tariffs than we do on certain products, we’ll raise ours to that level. That’s not exactly what’s happening, as a truly reciprocal situation would require a very complex administrative review of tariff codes and products. But it’s still early days.

What’s the overall takeaway at this time? As The Vision Council notes:

In the short term, increased import costs are likely to be passed along to consumers. However, there is potential for diplomatic negotiations to reduce or exempt certain tariffs, and other countries are expected to issue retaliatory tariffs, like China announced [on April 4], with a matching 34% tariff on imports from the United States. Industry efforts to diversify production across various countries in light of previous country-specific tariffs may need to be re-evaluated considering this new trade environment. (Source: The Vision Council Addresses New Reciprocal Tariffs and Their Impact on the Optical Industry)

Optical goods among most affected

The newly announced tariffs will stack on top of existing duties rather than replacing them. Here’s an example that illustrates the steep climb: Plastic eyeglass frames from China, a common product category, now carry a combined duty rate of approximately 64%. That includes:

• 2.5% standard duty
• 7.5% China Section 301 tariff
• 20% IEEPA duty
• 34% reciprocal duty

Over-the-counter readers, sunglasses, safety glasses, and goggles imported from China are also impacted. Eyeglass cases and some lens processing may face duty rates between 80 and 90%.

Broadly, we’ll need to keep an eye on retaliatory tariffs. [4/9/25 update: China just responded by increasing its retaliatory tariffs to 84% on U.S. goods.] The situation is very much developing.

4/15/25 update:

What ODs should watch

According to The Vision Council, in addition to cost increases, you’ll want to pay attention to compliance rules, especially around country of origin declarations. Goods that enter the U.S. after enforcement dates are subject to the full tariff rate, even if they were in transit prior.

The determination of origin is also a factor. Origin follows the principle of “substantial transformation.” That means if components are made in one country but significantly altered in another (changing their name, character, or use), the second country may be considered the origin. Mislabeling or misunderstanding this process can carry stiff legal penalties.

Growing concerns among ECPs

Surveys conducted by Jobson Research reveal escalating apprehension among ECPs regarding the financial implications of the new tariffs. In March, 76% of respondents expressed being very or somewhat concerned about the impact on the cost of goods, an increase from 70% in February. Additionally, 73% were worried about the effect on their bottom line, up from 66% the previous month. ​

For now, practices are responding in various ways:​

• Some are considering passing increased costs onto patients, with 42% indicating they would transfer 100% of the additional expenses. ​
• Others are exploring adjustments to their product portfolios, with 47% contemplating changes based on manufacturing origin.

What you can do

Supplier strategy now needs to be under closer review. Initiate conversations with your vendors to gain clarity on sourcing and pricing. You might look at diversifying your supply chain, adding vendors based in lower-tariffed countries or working more closely with domestic partners. If that’s not an option, think about consolidating orders to negotiate better volume discounts and reduce shipping frequency.

You probably shouldn’t make sweeping changes to pricing just yet, but explore the impact of small, targeted adjustments, keeping in mind that you’ll need to be prepared to explain potential price increases to patients and offer advice on cost-effective solutions.

Inventory management is another area to reconsider. You want to reduce overexposure to volatile categories while keeping your key products in steady supply. Look at your data to guide future purchasing decisions more closely.

And it almost goes without saying, but staying informed is non-negotiable. Our Optometry 411 newsletter will continue to bring you the latest updates and developments — and with so much still unknown, we can expect developments. Crucially, advocacy is underway. The Vision Council’s Government Relations team is in discussions with congressional leaders and key committees that influence the United States Trade Representative to push for the creation of an exemption process that would allow affected U.S. companies to formally petition for relief.

Recommended viewing: The Vision Council’s Omar Elkhatib and Rick Van Arnam Talk With VM About the Impact of Tariffs

Note: The Vision Council recently hosted an informational webinar and has a variety of resources available here for members to stay informed as the situation evolves. A recording of the webinar is available upon request by emailing media@thevisioncouncil.org.
4/15/25 update: A second webinar from The Vision Council will take place 4/16/25 at 1 p.m. CT.

The post Tariff Breakdown for ODs: What’s Happening, What It Means, and What You Can Do appeared first on Optometry 411.

A little history

Over the past 30 years, the scope of optometry in the U.S. has evolved fairly dramatically, from vision correction to comprehensive eye care, including management and treatment of ocular diseases like glaucoma and macular degeneration. Opportunities for expanded scope increased significantly in 1986 when the federal government classified optometrists as medical providers eligible for Medicare reimbursement.

Since then, legislative changes have allowed optometrists to prescribe medications, perform minor surgical procedures in some states, and play a part in managing systemic conditions. The profession has embraced advanced technology, pediatric care, and vision therapy, while tele-optometry and interdisciplinary care have expanded access to services. Optometrists are increasingly recognized as primary healthcare providers, though scope-of-practice laws continue to vary by state.

Where are we now?

Expansion of optometry’s scope of practice in the U.S. continues to gain momentum. There are currently 12 “laser states,” i.e., states in which scope includes the use of lasers. And more states pursued scope expansion for laser rights in 2024 than in any previous year. (Mid-2025 update: There are now 14 laser states.)

Education and residency programs have grown to reflect the legislative changes. Today’s optometry students are being taught to perform minor surgical procedures like lesion removal and subcutaneous injection and laser procedures like selective laser trabeculoplasty, YAG capsulotomy, and laser peripheral iridotomy.

This shift is not without opposition, however. Medical orgs have pushed back against these expansions, referring to it as scope creep, citing patient safety and the level of surgical training optometrists receive compared to ophthalmologists. Expanded scope has led to increased overlap between ophthalmologists and optometrists, which sometimes creates an unfortunate tension between the fields. One only has to read a little bit from either side to get a sense of the different tones (e.g., What’s the Difference Between Optometrists and Ophthalmologists? from the American Medical Association compared to Optometric Scope: Breaking Down Barriers from Review of Optometry).

To be fair, it’s not just MDs who have opposing views. Some ODs are not interested in performing scalpel or laser surgery, for example. But expanding access to high-quality patient care has so far proven to be a positive:

“[Level of training] is the only argument that ophthalmology has been able to claim, and it’s never come to fruition, but that’s what they cling to in every scope battle that comes along,” says Angelique Sawyer, OD, legislative co-chair of the New Hampshire Optometric Association, which is currently pushing to authorize lasers and advanced procedures. “We’re not asking for things that are outside of our training and education, and we’ve proven time and time again that when the legislature grants us authority and increased scope, we do it responsibly and to the benefit of our patients,” she says. (Source: Optometric Scope: Breaking Down Barriers, Review of Optometry)

Looking ahead

Despite some setbacks, such as a vetoed bill in California (and a second attempt still in limbo), several states are pressing forward, which signals the increasing role of optometry in the broader healthcare landscape.

[Dr. Nate Lighthizer, OD] reiterates that “optometrists have a great track record of safely performing [new] procedures,” but adds that there will always be political opposition. “I think the reason why some states struggle is because you have to have the right people in place to pass a law,” he notes. For example, scope advocates in states with legislators who are also medical doctors — such as West Virginia and California — may have a more difficult time hammering home the safety and necessity of OD-performed procedures. (Source: Optometric Scope: Breaking Down Barriers, Review of Optometry)

If the data is any indication, optometry scope expansion will reach more states: A recent study examining the effect of optometrists’ prescription authority found that granting optometrists the ability to prescribe therapeutic pharmaceutical agents improved public eye health. The study revealed that vision impairment decreased by 12% on average over a 15-year period following the expansion of optometry’s scope.

“The effect was not instant but emerged six years after the policy change. Moreover, the policy brought a more significant decline in vision impairment among the nonwhite population, who might have more limited access to medical care than white people.” (Source: Seeing Is Believing: The Effects of Expanding Optometrists’ Scope of Practice)

Findings from the study imply that allowing optometrists to practice to the full extent of their training might encourage them to provide higher-value services, which will further improve public eye health. The thinking is: Empowering optometrists improves care access by reducing reliance on ophthalmologist referrals.

The post Will Physician Shortages Mean Further Expanded Scope for Optometrists? appeared first on Optometry 411.

Here’s a snapshot of where pediatric eye care stands currently: 

The Great Ophthalmologist Gap: Amazingly, 90% of counties lack a single pediatric ophthalmologist. This number hasn’t budged since last year. 

Optometrists? It’s Even Worse: In 2023, a whopping 93.5% of counties lacked a single pediatric optometrist. 

Urban vs. Rural Divide: Eye care deserts tend to be in rural areas, with city dwellers having nearly double the access to pediatric eye specialists. 

Money Talks: Counties with higher median income were more likely to have pediatric eye specialists. This suggests that poverty plays a role in access to care. 

The study also highlights an interesting overlap. Counties with a pediatric ophthalmologist were more likely to have at least one pediatric optometrist, but most of these counties still lacked one entirely. 

What this means for optometrists: The need for pediatric eye care is clear. This study can be a springboard for advocacy efforts to improve access to vision care for children across the US. By working with policymakers and healthcare organizations, optometrists can play a crucial role in ensuring all kids have a shot at seeing the world clearly. 

SOURCE: JAMA Ophthalmology  

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While it has not happened yet, the UN is making progress toward recognizing vision care and specifically optometry as its own entity. This would allow for the creation of legislated public health programs, like the existing InfantSEE program managed by Optometry Cares, to provide funding to support the optometry sector in the same way ophthalmology sector is currently being funded and supported.  

Worldwide recognition for eyecare and optometry is a slow process. However, optometry professionals and leaders believe that the “Vision for Everyone Resolution” passed unanimously by the UN General Assembly in 2021 provides a framework for future recognition of optometry as its own entity. Some of this needed recognition could come at the UN 2024 Summit of The Future. At the summit, the UN’s 2030 Agenda known as the “Pact of the Future” includes the initiative that supports eyecare and optometry. But optometry is siloed within the non-communicable diseases category and optometry is not yet recognized as its own category. 

According to optometry leaders, one reason the optometry sector is not recognized as its own entity is that some countries strictly recognize ophthalmology as a solution for the preventable treatment of blindness. “We as optometrists are not recognized everywhere in the world, I am slowly chipping away at educating legislators and government officials to recognize the value that they’re missing out on in their own country to the detriment of their citizens if they don’t include optometry in the solution to this problem,” says Dr. Scott Mundle. Trustee of the World Optometry Foundation (WOF). 

Optometry professionals stress that optometry is collaborative with ophthalmology and not competitive in the fight to treat preventable blindness. “Optometry doesn’t take work or business away from ophthalmology. There are not enough of them [ophthalmologists] to provide the care that … people need.” 

The optometry sector should be strengthened and further recognized by all countries when the UN General Assembly convenes at the UN 2024 Summit of the Future. The UN 2030 Agenda, which includes the initiative for eyecare, if ratified will bring additional recognition to the optometry sector that optometry leaders and professionals are seeking. 

Sources: United Nations, InfantSEE. Eye Care Business Canada 

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