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Guest View | Bills would help Virginians’ access to eye care

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Amanda Umlandt | president-elect of the Virginia Optometric Association

In 2009, I was preparing to graduate from optometry (OD) school, concluding eight years and thousands of hours of specialized training concentrated on the eyes and the systemic diseases and conditions that can affect them.

I was excited and moving to Tulsa, Oklahoma, for a residency program — a unique program that trains ODs to perform therapeutic laser treatments and provides supervised training in ocular disease and peri-operative management. This was one of a handful of programs training ODs to perform laser procedures during a competitive one-year program.

At the time, Oklahoma was the only state permitting optometrists to perform these in-office procedures to treat glaucoma and provide after-cataract surgery care. I didn’t want to live in Oklahoma forever, but I knew there were many people who were realizing Oklahoma optometrists were performing these procedures safely — and that other parts of the country could benefit from updated laws. These laws would allow patients to receive treatments closer to home, thus improving access to care. I decided I would settle in a state where I would help change the laws and use the skills I’d be gaining through my residency program.

My journey led me to Virginia’s Eastern Shore and later to rural Appalachia in Grundy. During my 10 years in Virginia, I’ve seen countless patients who needed procedures I have performed hundreds of times in Oklahoma — and could perform in nearby Kentucky — but am restricted from performing them in Virginia. Rather, my patients often have to travel two to three hours to receive recommended laser treatments. That requires planning, time, family support and financial investment.

There are now eight states where optometrists are able to perform these laser procedures. There are many more programs training optometrists to perform these procedures and excel in their delivery. These procedures are quick, safe and part of every graduating optometrist’s education and experience. Being able to provide this care to my patients isn’t about reimbursement. It’s about access to care and providing the highest level of care to patients, no matter where they live.

Optometry is a legislated profession — meaning the commonwealth, rather than my training and qualifications, dictates what services I’m allowed to provide. House Bill 213 and Senate Bill 375 are being introduced this year and would allow Virginia’s optometrists to perform three in-office laser procedures to treat glaucoma and provide after-cataract surgery care. If the bill is passed, you won’t have to travel to an ophthalmologist if the optometrist in your hometown is trained to perform these procedures. To be clear, Virginia’s doctors of optometry are not seeking to perform Lasik, cataract surgery or injections.

According to a 2018 work force study by the Virginia Department of Health, there are more than twice as many optometrists as ophthalmologists in Virginia. Expanding our scope of practice to include certain laser procedures would better serve our patients. As an added benefit, doctors like myself who already have the training and experience may find Virginia a more attractive place to live and practice.

Please ask your legislators to support HB 213 and SB 375 to allow Virginians to see more clearly. For more information, visit

Amanda Umlandt OD, FAAO is an optometrist with the Virginia Eyecare Clinic in Grundy, Virginia and president-elect of the Virginia Optometric Association.


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As he settles into office, Gov. Glenn Youngkin looks an awful lot like one of those “inherently divisive concepts” he seeks to ban from the classroom. It’s one thing to campaign to a soundtrack of dog whistles and yet another to pitch your governance that way.

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