Tennessee's and Vermont's Laser Laws, Taking Effect in 2028

In 2026 two more states wrote laser procedures into their optometry laws: Tennessee in April and Vermont in June. Both laws have long runways. Vermont's takes effect July 1, 2028, and Tennessee's laser provisions start Jan. 1, 2028. Until those dates, optometrists in either state may not perform laser procedures under the new authority, and a credential will be needed even after them.

For an optometrist licensed in one of these states, or planning a move there, the next two years are for lining up the course, the NBEO exams and the supervised procedures so the credential is ready when the law is.

Which procedures does Vermont's Act 171 authorize?

Act 171 (S.64), signed by the governor on June 18, 2026, amends 26 V.S.A. chapter 30. It creates an Advanced Therapeutic Procedures Specialty that an optometrist licensed in Vermont may apply for. A specialty holder may perform:

• Three laser procedures: laser capsulotomy, laser peripheral iridotomy and laser trabeculoplasty.
• Limited surgery: excision and repair of nonrecurrent chalazia, excision and biopsy of small benign-appearing adnexal lesions, closure of the resulting wounds, repair of small eyelid lacerations, and corneal crosslinking.
• Injections: therapeutic agents into the eyelid or adnexa including the subconjunctival space, injections for fluorescein angiography, and epinephrine for anaphylaxis.

The act also lists what stays off limits for every optometrist, including retinal laser procedures, LASIK, PRK and all other refractive surgery, intravitreal injections, cataract surgery and corneal transplants. It keeps Schedule I and II drugs out of scope except hydrocodone combined with analgesics, capped at a 72-hour supply with no refills. The whole act takes effect July 1, 2028.

What does the Vermont specialty require?

The qualifications are in the new 26 V.S.A. § 1724:

1. A Vermont optometry license. The specialty sits on top of the license.
2. A course, depending on graduation year. Optometrists who graduated before 2019 must complete a board-approved postgraduate course of at least 32 hours covering laser physics and safety, gonioscopy, laser therapy for open-angle and angle-closure glaucoma, posterior capsulotomy, peripheral iridotomy, trabeculoplasty, minor surgery, local anesthesia and office emergencies, among other topics. Graduates from 2019 on need no additional coursework.
3. A preceptorship. At least eight hours of supervised clinical training with hands-on performance on live patients of at least two each of laser trabeculoplasty, posterior capsulotomy, laser peripheral iridotomy, chalazion excision, chalazion injection and lesion excision or drainage.
4. NBEO exams. Passing written and clinical NBEO exams, including the Injections Skill Examination (ISE) and the Laser and Surgical Procedures Examination (LSPE), plus anything else the board adds by rule.

The preceptor must be an ophthalmologist or an optometrist who has been licensed for at least three years to perform these procedures in some U.S. jurisdiction. Supervision is direct and in person, and the preceptorship must take place in a state where the preceptor is licensed and authorized to perform the procedures. Because Vermont optometrists cannot perform them until 2028, that will usually mean training in another state. The preceptor certifies completion and sends the procedure log to the board.

Can an optometrist from another state get the Vermont specialty by endorsement?

Yes. The board may issue the specialty to an applicant licensed and in good standing in another U.S. jurisdiction whose expanded scope is substantially equivalent to or broader than Vermont's and who has been in good standing in that scope for at least three years. An optometrist granted the specialty this way may also serve as a preceptor in Vermont.

The underlying license is a separate application. Vermont licenses optometrists by endorsement with NBEO scores, transcripts, CPR and verification from the first and most recent states, with no years-of-practice minimum, and OPR says NBEO scores must be used within three years of passing. The license fee was $395 as of October 2026, renewing at $325 every two years by July 31 of even years. See the Vermont license page.

How do Vermont renewals change?

Vermont already requires 40 CE hours each two-year period and current CPR. Specialty holders add five hours in advanced procedures each period. Any adverse event related to an advanced procedure must be reported within 30 days. The act also grows the Board of Optometry from five members to seven, and from Jan. 1, 2031 at least one optometrist member must hold the specialty.

What is known about Tennessee's law?

The American Optometric Association reported on April 15, 2026 that Tennessee had become the latest state to authorize optometrists to use ophthalmic lasers. According to that report, part of the bill took effect immediately so the Board of Optometry can write rules, and the remaining provisions take effect Jan. 1, 2028. Once certified, Tennessee optometrists will be able to perform laser peripheral iridotomy, selective laser trabeculoplasty and YAG capsulotomy. The law prohibits LASIK and PRK, retina procedures, cataract surgery, corneal transplants and most non-laser incisional surgery.

Two cautions. We have not yet read the Tennessee statute itself, so the summary above is the AOA's. And the certification requirements will come from board rules that had not been published as of October 2026. The current rules, Tenn. Comp. R. & Regs. 1045-02-.11, still exclude retina laser procedures and laser or non-laser procedures in the vitreous chamber. Until the board publishes its rules, nobody can say which course, exam or proctoring counts.

The Tennessee license itself is unaffected. Applicants pass all parts of NBEO and an open-book jurisprudence exam mailed by the board (90 percent passes), file two reference letters from optometrists and a background check, and have every state ever licensed send verification, with no years of practice required. The application fee is $150. See the Tennessee license page.

Is Kansas part of this?

Kansas passed a scope bill, HB 2223, in March 2026, and the AOA describes it as adding laser capsulotomy and laser trabeculoplasty for credentialed optometrists. We have not confirmed its effective date or how the board will credential optometrists, so we do not yet treat Kansas as a state where optometrists may perform lasers. Watch the Kansas board's rules.

How should you plan for 2028?

• Book the LSPE and ISE early. Both are given only at NBEO's testing center in Charlotte, and NBEO releases clinical exam scores in the first full week of a set month, about two months after the exam. See ISE and LSPE requirements.
• Check your graduation year. In Vermont, a pre-2019 graduate needs the 32-hour course; a later graduate does not.
• Find a preceptor in a state where these procedures are already legal. Keep a dated log of each procedure; Vermont wants it from the preceptor.
• Keep the license current first. A specialty cannot be issued on a lapsed license, and Vermont's renewal date falls on July 31 of even years, a month after the act starts.
• Wait for Tennessee's rules before paying for a course aimed at Tennessee certification.

Where do we fit?

Our Laser & Advanced Procedure Credential service ($399 per state) assembles the course certificate, preceptor log and NBEO score reports into the board's specialty application and tracks it; you review and sign it, and you sit the exams and perform the procedures. If you also need the license, the Optometry License, One State service is $699. Prices are on the pricing page, and the wider picture is in how states decide on laser procedures.