Laser Procedures and Optometry: How Each State Decides

Laser authority is the part of optometric scope that varies most from state to state, and it is decided in one place: the state's optometry practice act or the board rules written under it. A national exam can show that you know how to perform a YAG capsulotomy. Only a statute can make it legal for you to do it on a patient in that state. If you are moving or practicing in more than one state, the question is never "am I laser certified?" but "does this state's law allow it, and what credential does this board issue?"

The answers below come from each state's statute or rule as of October 2026. Where we have not read the law itself, we say so rather than guess.

How does a state grant laser authority?

States that allow optometric lasers usually do three things in the same law. They name the procedures, typically some combination of YAG capsulotomy, laser peripheral iridotomy (LPI) and selective or argon laser trabeculoplasty. They exclude others by name, almost always retinal laser and refractive surgery such as LASIK and PRK. And they make the authority conditional on a separate board credential, earned through a course, supervised procedures on live patients and, increasingly, NBEO's Laser and Surgical Procedures Examination (LSPE).

That third piece matters for anyone licensing in another state. The license and the laser credential are separate approvals. A board can grant you a license on NBEO scores and still require its own laser application before you touch a laser in that state.

Which practice acts list laser procedures today?

• Alaska. With board authorization after an approved course, optometrists may perform expanded therapeutic procedures, which may include YAG capsulotomy, laser peripheral iridotomy and laser trabeculoplasty. Retinal laser, LASIK and PRK are excluded (AS 08.72.278; 12 AAC 48.040).
• Arkansas. The practice act includes laser capsulotomy and laser trabeculoplasty. Optometrists certified for laser procedures report outcomes to the board, which charges a separate advanced procedures license fee (Ark. Code Ann. §§ 17-90-101(a)(3)(D), 17-90-206).
• Louisiana. Optometry includes YAG laser capsulotomy, laser peripheral iridotomy and laser trabeculoplasty, with retinal laser and refractive surgery excluded (La. R.S. 37:1041). The board's once-a-year licensing exam includes a practical with YAG capsulotomy, YAG iridotomy and SLT stations.
• Mississippi. Optometrists certified by the board may perform YAG laser posterior capsulotomy (Miss. Code Ann. § 73-19-1(5)). The optional Primary Eyecare Procedures (PEP) certification costs $750 and needs a board course, a written exam, a skills assessment and 8 preceptor hours.
• Montana. Optometrists may perform anterior segment laser procedures, excluding refractive surgery and intravitreal injection, only after the board certifies their accredited didactic and clinical laser training (Mont. Code Ann. 37-10-101(3), 37-10-302(5), amended in 2025).
• Oklahoma. The statute's scope includes laser surgery procedures, excluding retina procedures and LASIK, after board certification (59 O.S. § 581(D)). Every licensure candidate must pass a laser therapy course for the anterior segment before sitting the State Board Exams, which are given once a year.
• South Dakota. SLT and YAG capsulotomy have been in scope since July 1, 2024, after board certification only: a board-approved course of at least 32 hours, proctored competency on live eyes (ten eyes for YAG capsulotomy) and, for graduates after July 1, 2024, the LSPE (SDCL 36-7-1(9), 36-7-1.4).
• Virginia. A separate laser surgery certification needs a dean or course attestation covering 12 topics plus the LSPE laser section or proctored sessions (18VAC105-20-80). From Jan. 1, 2033, every new applicant must meet it (18VAC105-20-10(B)).
• West Virginia. Laser certification covers YAG capsulotomy, SLT and peripheral iridotomy, and full certification takes 5, 5 and 4 proctored procedures on a live eye with a board-approved proctor (W. Va. Code 30-8B-4, 30-8B-5). Every West Virginia license issued since July 9, 2025 carries oral, injection and laser certification.

The list is deliberately limited to laws we have read. Other states have passed or debated scope bills, and advocacy groups publish their own tallies. A tally is not a statute, so check the practice act of the state you are moving to, or ask us to.

Which laws take effect later?

Vermont enacted Act 171 (S.64), signed June 18, 2026, which creates an Advanced Therapeutic Procedures Specialty. From July 1, 2028, specialty holders may perform laser capsulotomy, laser peripheral iridotomy and laser trabeculoplasty. Tennessee passed a law in April 2026 that, according to the American Optometric Association, lets certified optometrists perform LPI, SLT and YAG capsulotomy from Jan. 1, 2028, with the board writing its rules first. We have not yet read the Tennessee statute itself, and Tennessee's current board rules still exclude retina laser procedures. Both are covered in Tennessee's and Vermont's laser laws taking effect in 2028.

Where does the law rule lasers out?

Many practice acts say so plainly. Optometrists may not perform laser procedures in these states under the current statute:

• Connecticut: advanced optometric care excludes therapeutic lasers (Conn. Gen. Stat. § 20-127(a)(1)).
• Delaware: the practice act prohibits ophthalmic lasers and surgery (24 Del. C. § 2101(a)(2)).
• Idaho: optometry does not include the use of therapeutic lasers (Idaho Code § 54-1501(4)).
• Maine: optometric treatment is care "without the use of invasive surgery or tissue-altering lasers" (32 M.R.S. § 19101).
• Nebraska: optometry does not include surgery or laser surgery (Neb. Rev. Stat. 38-2605(2)).
• Nevada: no procedure that cuts, burns or vaporizes tissue by laser is authorized (NRS 636.025(2)).
• New Hampshire: surgery, defined to include therapeutic and photorefractive lasers, is excluded (RSA 327:1).
• North Dakota: laser therapy and invasive surgery are not permitted (N.D.C.C. 43-13-01(2)).
• Oregon: optometry means any means other than invasive or laser surgery (ORS 683.010(3)).
• South Carolina: optometrists may not perform surgery, including laser surgery (S.C. Code 40-37-310(D)).
• Washington: the advanced procedures endorsement includes no laser procedures, and the statute bars ophthalmic surgery by laser outside that list (RCW 18.53.010).
• Wisconsin: the statute excludes surgery and contains no laser authorization (Wis. Stat. 449.01(1)(b)).

Washington and South Carolina come up often because both have expanded scope in other ways. Washington's advanced procedures endorsement covers chalazion removal, injections, lid lesions and eyelid surgery; South Carolina requires glaucoma authority of endorsement applicants. Neither law allows lasers.

What does a laser credential usually require?

The pieces repeat across states even though the numbers differ:

1. A course. South Dakota requires at least 32 hours, and Vermont requires a 32-hour postgraduate course of optometrists who graduated before 2019. Virginia lists 12 required topics. Oklahoma requires every licensure candidate to pass an anterior segment laser therapy course before its State Board Exams.
2. Supervised procedures on live patients. West Virginia counts 5, 5 and 4 by procedure; South Dakota counts ten eyes for YAG; Vermont requires at least two of each laser procedure in an 8-hour preceptorship.
3. A national exam. The LSPE laser section appears in South Dakota, Virginia, West Virginia and Vermont, sometimes with a course alternative. See ISE and LSPE: states that ask for them.
4. Ongoing duties. Arkansas licensees report outcomes, West Virginia requires 2 CE hours in laser or advanced procedures each cycle, and Vermont specialty holders report any adverse event within 30 days.

Does a laser credential follow you to a new state?

No. Each board issues its own credential under its own statute, so a laser certification in one state is evidence for the next board, not authority there. Vermont's law is a good example of what an endorsement path looks like: its board may issue the specialty to an optometrist who holds substantially equivalent expanded scope elsewhere and has been in good standing in it for at least three years. Expect each board to want the course certificate, the procedure log and the LSPE score report again.

The reverse problem is common too. An optometrist who performs SLT at home and takes a job in a state whose act excludes lasers simply cannot perform it there, whatever the credential at home says. And in West Virginia the credential comes first: reciprocity applicants must already hold oral, injection and laser certification before they apply. If your current scope is narrower than the new state's, read when your home state's scope is narrower.

How do we help with laser credentials?

The Optometry Licensing Readiness Review ($149, credited in full toward a first application) reads the target state's statute and tells you whether lasers are allowed, which credential applies and which documents you already have. Our Laser & Advanced Procedure Credential service is $399 per state: we assemble course certificates, proctor logs and the NBEO score report into the board's credential application and track it, and you review and sign it. You sit the LSPE and perform the supervised procedures yourself. State-by-state requirements are on the state license index, including West Virginia and South Dakota.