Alaska may let unlicensed eye-clinic staff do routine eye care, with no set training standard

Alaska is preparing to let unlicensed staff in eye clinics perform routine eye-care tasks, under what the state calls its first written rules for handing such work to someone who holds no license — and without any board-set training credential behind it. The Board of Examiners in Optometry published the proposal Wednesday, with comment open through Sept. 21.

Under the rules, an optometrist could delegate a routine service as long as it falls within the optometrist's own scope of practice, the staffer has been trained to do it "safely and competently," and the optometrist supervises the work and stays responsible for it. A "routine" service is defined loosely — one that happens often, has a standard procedure and predictable results, and carries minimal risk. The proposal names no specific tasks, but bars several categories outright, including anything involving pain management or opioids, diagnosing a patient, forming a treatment plan, counseling, or giving injectable medication.

The law leaves one requirement to the board that the board has decided not to impose. The 2024 law behind the rules directs the board to allow delegation but says unlicensed staff can only perform tasks that meet "standards established by the board." The board says it doesn't intend to set a fixed training standard, explaining that leaving it open "provides flexibility to the optometrist to decide how to train and supervise." Some other Alaska licensing boards do set such a bar — the veterinary board, for instance, must establish training requirements before duties pass to veterinary technicians.

The authority to do this is new. As recently as 2023, a state assistant attorney general concluded the board had no power to allow delegation to non-optometrists at all. The Legislature then passed the law that granted it, and the board now points to that statute as its authority.

The idea drew patient-safety objections before it became law. The American Academy of Ophthalmology urged legislators to reject the bill, warning it "jeopardizes patient safety by authorizing optometrists to delegate the care of patients without sufficient guardrails." The bill's sponsors countered that without the ability to delegate, some Alaska practices could close — a real risk in regions with few optometrists. No one has weighed in on the current rules yet; the opposition on record was written against the bill before it passed.