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Optimizing Optometric Scope: A Safe, Evidence-Based, and Essential Step Forward to Improve Access to Care

The Canadian Association of Optometrists (CAO) is working closely with governments across Canada to optimize optometrists’ scope of practice as an essential, evidence-based response to growing eye health needs.

With aging populations, more chronic eye disease, and increasing strain on specialist capacity, provinces are looking to proven, safe solutions that improve patient access to timely care.

In both Alberta and Ontario, regulators are reviewing safe additions to optometrists’ authorized procedures, specifically in-office, non-sedated interventions such as YAG capsulotomy for secondary cataracts, selective laser trabeculoplasty (SLT) for glaucoma management, and removal of benign eyelid lesions. These procedures are already included in North American optometry curricula and are performed safely by optometrists in multiple U.S. states and in the U.K.

“As the front line of vision health and eye care, optometrists are highly trained, regulated professionals who already provide comprehensive diagnosis and management of ocular disease,” said Dr. Allison Scott, President of CAO. “Optimizing scope is about ensuring patients can receive safe, effective care sooner. Optometrists and ophthalmologists both play essential roles. Optimized scope simply allows each profession to work to its strengths while keeping patient safety at the centre.”

Canada faces pressing access challenges: months-long specialist wait times, rapid increases in glaucoma, diabetic retinopathy, and age-related macular degeneration, and persistent gaps in rural and northern communities.

With 7,135 optometrists across Canada – compared to 1,382 ophthalmologists – allowing optometrists to provide routine in-office procedures will reduce delays, support earlier intervention, and allow ophthalmologists to focus on complex surgeries that require their expertise.

Optometrists are not seeking authority to perform intraocular surgeries such as cataract extraction, retinal operations, or corneal transplants. The proposed updates involve only the safe, office-based procedures aligned with their training and international standards.

Optometrists complete seven to eight years of post-secondary education, including a Doctor of Optometry degree with extensive training in ocular disease, pharmacology, laser concepts, systemic disease, and supervised clinical practice over multiple years. Advances in the education and training of optometrists have outpaced their existing scope of practice. Doctors of Optometry are already educated and clinically trained to practice at a higher level than legislated.

To maintain licensure, optometrists must also complete ongoing continuing education, ensuring that their clinical skills remain current, evidence-based, and aligned with evolving standards of care.

Their safety record is well established:

  • A review of 146,403 laser procedures performed by optometrists in the U.S. found a complication rate of 0.001%1.
  • A 2023 study in Optometry & Vision Science found YAG capsulotomies performed by optometrists to be safe and effective, with 99% patient-reported vision improvement, 95% objective improvement, and no significant adverse events2.

“These procedures are well within optometric training and are performed safely worldwide,” said Dr. Scott. “Our profession’s record speaks for itself: optometrists put patient safety first in every clinical decision we make, upholding the highest clinical standards, and acting in their best interests.”

CAO will continue working with governments, regulators, and vision care partners to ensure Canadians – especially those in underserved communities – have access to timely, optimal eye care without compromising safety.

1 Lighthizer N, Patel K, Cockrell D, et al. Establishment and review of educational programs to train optometrists in laser procedures and injections. Clin Exp Optom. 2025;108(3):248-257. doi:10.1080/08164622.2024.2380075

2 Lighthizer N, Johnson S, Holthaus J, et al. Nd:YAG Laser Capsulotomy: Efficacy and Outcomes Performed by Optometrists. Optometry and Vision Science 100(10):p 665-669, October 2023. | DOI:

10.1097/OPX.0000000000002057

Click HERE for the press release.

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