This commentary is by Alexander Van Dyck of Montpelier. He practices optometry in Williston.
I didn’t always know I wanted to be an optometrist — my first career was as an audio engineer — but I did know I wanted to do something fulfilling and stable. While I grew up familiar with optometry, watching my grandfather work at his optometry practice, it wasn’t until my mid-20s that I decided to pursue a degree in the field.
I completed my education, including advanced studies in anterior segment disease and a residency in ocular disease, at the Pennsylvania College of Optometry.
Residency is optional for optometrists, but I wanted to gain additional experience — often equated to four or five years in general practice — by working alongside some of the best professionals in the field.
After graduating in 2018 and completing my residency in 2019, I worked in an ophthalmology practice in the Washington, D.C. area, where I learned the value of collaborative care between optometrists and ophthalmologists.
I also witnessed the challenges created by restrictive state laws.
Entering the workforce, Vermont stood out as a place where my skills were needed. I was attracted to the quality of life here, but what ultimately convinced me was the overwhelming shortage of optometric care, particularly for routine and disease management services, and in rural areas lacking access.
Like D.C., Vermont’s scope of practice laws currently prevent optometrists from performing certain procedures they are fully trained to do, forcing patients to wait for long periods of time between appointments or travel out of the state for care.
In my practice, I often see a common post-cataract surgery condition called posterior capsular opacification, which can be treated with a quick, low-risk laser procedure. In states where optometrists are allowed to work under a full scope, this procedure can be easily performed in the office when it is identified.
In Vermont, patients might wait weeks or months for an available ophthalmologist.
The same is true for administering steroid injections to treat small lumps and bumps. Optometrists are trained to perform these procedures, yet we must refer our patients out because of outdated regulations.
The proposed optometric scope expansion bill is not about pushing boundaries or patient convenience. It’s about creating more access to vital health care services by allowing optometrists to provide their patients a full spectrum of care to better serve their communities.
Long wait times have a significant impact on elderly patients, those on Medicaid and people in rural areas who already struggle with accessing health care.
Expanding the optometric scope would allow patients to receive timely care while reducing the burden on overextended ophthalmologists, who could then focus on more complex surgeries like retinal repairs, corneal transplants and cataract surgery.
Beyond patient care, expanding Vermont’s optometric scope would likely have a positive economic impact on Vermont. The state would become a more attractive place for optometrists to live and work, creating job opportunities and encouraging young professionals to settle here.
It would also minimize the need to refer patients outside the state’s borders for care.
When I moved to Vermont, I knew I would be limited in my work due to state laws. But it is frustrating to see patients suffer unnecessarily because of outdated regulations.
Health care policy should be based on education and evidence — not arbitrary restrictions.
By expanding the optometric scope, Vermont has an opportunity to improve patient care, reduce wait times and welcome more optometric professionals.
The time to act is now.
Read the story on VTDigger here: Alexander Van Dyck: Outdated regulations and lack of providers make Vermont eye care challenging.