Photo courtesy of Dr. Joseph Munsell, seen here demonstrating a YAG laser procedure to an optometry student. Dr. Munsell shares tips on incorporating optometric laser procedures in your practice.
Adding optometric laser procedures to your practice
By Joseph M. Munsell OD, Diplomat, ABO
July 30, 2025
When Wyoming passed its optometric scope expansion bill in 2021, I knew our practice was about to change for the better.
The new law allowed optometrists like me to perform noninvasive laser procedures—specifically YAG capsulotomy, SLT and LPI—procedures we were thoroughly trained for in school but had not been permitted to do in practice until then.
As soon as it became clear the bill would pass, we purchased our laser and quickly integrated it into our office.
Meeting Patient Needs—Right in Our Office
The impact on our patients, especially those who are older, was immediate and profound. In our first year offering laser procedures, we performed over 300 cases.
Many of these were for geriatric patients who, before the law, often faced the inconvenience and burden of traveling long distances to get the care they needed. Being able to perform these sight-saving procedures locally allowed them to stay with a familiar provider and avoid additional travel stress.
Training and Certification: What It Took to Get Started
While my foundational training covered all the motor skills needed to perform laser procedures, Wyoming required an additional certification.
I traveled to Oklahoma for an intensive 32-hour weekend course covering laser theory, procedural concepts and hands-on wet labs. The course cost a few thousand dollars, and I also had to demonstrate proficiency on a live patient under a qualified practitioner’s supervision. Requirements like these vary by state, so check with your state board about specifics.
Investing in the Right Equipment
Choosing the right laser was our biggest financial decision. We opted for a dual laser that handles all three core procedures, paying $24,000 on a lease at $790 a month for 36 months. Leasing allowed us to get started immediately without a huge lump sum.
Immediate Profitability and Strong ROI
From the beginning, our investment proved worthwhile. In our group setting, we had a robust supply of intra-clinic and inter-clinic referrals. Thanks to favorable insurance reimbursement rates, we only needed to perform three procedures a month to break even, and four to show a profit.
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In reality, we averaged 20 procedures per month, so we reached full equipment payoff in just four months. The procedures themselves bring in about $60,000 per year in reimbursement alone—without counting additional visits for post-op care and prescriptions, which further increase revenue.
Patient Success Stories
Some procedures stand out for their life-changing impact. YAG capsulotomy, for example, can restore driving vision in minutes.
I’ll never forget a patient who went from 20/60 and unable to drive to 20/20 in a single visit. Another case involved an 88-year-old glaucoma patient with arthritis so severe she could no longer use eye drops. After a successful SLT procedure, her pressure was controlled without drops, giving her the independence she thought was lost.
Getting the Whole Team Ready
Introducing laser procedures meant new training for my surgical technician, who needed to master every step from consultation to post-op care. We spent time together one-on-one, and the rest of the staff were brought up to speed so they could confidently answer patient questions about our new service.
For others considering the transition, the AOA’s paraoptometric surgical assisting course is a worthwhile resource for staff.
Knowing Your Patient Population
Before we made the leap, I looked at our demographic data. Our practice has a large older patient base and we routinely fielded questions about offering laser procedures in-house. There was no doubt the demand—and the promise of strong utilization—was there.
Insurance Coverage and Practice Revenue
Because these laser procedures are medically necessary, they almost always fall under patients’ medical insurance. With average reimbursement around $270 per procedure, the numbers add up quickly. Between direct reimbursements and secondary gains from post-op care and added services, practice value—and profitability—both climb.
Looking Forward
Currently, we perform every laser procedure legal in Wyoming, but as scope expands and the eye care landscape continues to evolve, I’m eager to add even more treatment options for my patients.
Tips for Optometrists Considering Laser Procedures
If you are hesitant about bringing laser procedures into your practice, reach out to colleagues who have already made the leap. Our profession is full of supportive peers who want to see each other succeed.
Editor’s note: States that currently allow ODs to perform the procedures described in this article include Alaska, Arkansas, Colorado, Indiana, Kentucky, Louisiana, Mississippi, Montana, Oklahoma, South Dakota, Virginia, West Virginia, Wisconsin and Wyoming. In 2024, Mississippi passed a law granting ODs authority to perform many medical procedures, including lasers, with regulatory rules currently being developed. In West Virginia, laws enacted in 2024 allow ODs to perform certain minor surgical and laser procedures, though implementation timelines and details are still evolving.
The specific procedures permitted and training requirements differ by state. Not all procedures may be authorized in every state mentioned, but YAG, SLT and LPI are the most commonly permitted.
Always check with your state’s board of optometry for up-to-date, practice-specific regulatory details. Read more about recent legislative scope of expansion wins HERE and HERE.
Read another article by Dr. Munsell here.
Joseph M. Munsell OD, Diplomat, ABO, is the owner of Cheyenne Vision Clinic in Cheyenne, Wyo. To contact him: jmunsell25@gmail.com
