Where is Opticianry Headed? The Case For Licensure

Discussions on opticianry today usually revolve around talk about how more than half of the states require nothing but a pulse to call oneself an optician, or how easy and watered down the national exams are, or how there’s little consistency across licensing states regarding requirements and scope of practice, or how no new states have adopted opticianry licensure in more than thirty years.  It seems to me that this line of thinking is all wrong, and we’ve gone about fixing the issues in a way that will guarantee more of the same.

Licensed states in green – non-licensed in red

First off, we often hear how only 21 states (42%), or, including Puerto Rico, 22 jurisdictions (43%) license opticians, leading one to believe that the majority of the population may be unconcerned with optician licensing.  This is clearly not the case, though, as shown below.  More than half (52%) of the US population is served by licensed opticians, clearly indicating the need for licensure (see chart below). I’m not sure why so many are always in a rush to point out how we’re failing, rather than showing how we’ve succeeded.

Secondly, the exams must reflect the current level of practice, so if you‘re a veteran optician bemoaning the current generation of opticians, ask yourself; who trained them? Yep, it was us.  Maybe we need to look in the mirror and see that the problem is us.

The lack of consistency across licensing jurisdictions, I believe, is one of the main reasons for the failure to adopt licensure laws in any new states in decades.  When one licensing state only requires basic exams, while another requires a two-year degree, and fewer than half require licensure at all, it’s difficult to make a case for licensure to the legislatures of non-licensing states. Each state board does what they feel is best for its respective public, but this has done little to protect the national population as a whole, makes it difficult for opticians to move from state to state, and calls into question the licensure itself.  Ask yourself, why are opticianry practice and requirements so different in Hawaii, Florida, New Jersey, and Connecticut?  Are eyes different in these states?

With the advent of the ABOP and NCLEP exams in 2016, we’ve seen several states adopt these simple, widely available, computer-based exams, making movement from state to state easier, but there’s still little consistency in requirements or scope of practice across jurisdictions. The fact that, of all the allied healthcare professions, opticianry is the only one still accepting apprenticeship as an accepted method of training is, in my opinion, the leading cause of the state of opticianry in 2020.

Where do we go from here?  First, we must change the way we look at this industry.  Let’s look at the positives.  Stating “more than half of the US population is served by opticians” is a more convincing position that licensure is a good, vs stating “less than half the states require it.”  Requiring a formal education is also a positive, and to achieve this, grandfathering is a must, when possible, to maintain support in the industry.

For the last ten years, I’ve heard from the previous generation’s movers and shakers that the industry leaders are lacking formal education themselves, and so don’t support it.  There’s some truth to this, but why do we as an industry continue to allow it?  It’s past time to demand consistency across jurisdictions, and the place to start is with your state board.  I’m running for a seat on the SC board. I’m also looking into the requirements for starting an opticianry program here in SC.  It’ll probably start small, perhaps as a certificate program, and then develop it into a full two-year degree. It’s essential that the state board support and eventually require such a program, and then eliminate the apprenticeship route to licensure. Where the board can adopt rules to more closely align with other state boards, it should. Where legislation is required, the board should recommend such changes.

If your board isn’t making the changes you need, then maybe it’s time to make some changes to your board.  Run for office.  Build support within your state opticianry association.  Connect with leaders of other associations and boards.  The old ways haven’t been working.  If opticianry isn’t rescued from its past, it won’t have a future. Once a consistently high standard can be shown across all of the licensing states, and that they are serving more than half the population, it’ll be easier to make a case before non-licensing states’ legislatures for why a license is needed.



Population data sourced from https://www.census.gov/data/tables/time-series/demo/popest/2010s-state-total.html

Licensing data sourced from https://www.abo-ncle.org/ABO/Exam_Information/Licensing_Boards/ABO/Boards/Licensing_Boards.aspx?hkey=c38ffeae-0ffb-472c-87ab-4bed32837354


  1. What clinical evidence can you share to show the benefits of licensure? Without this, you will find expansion of licensure very challenging. If US opticianry wants higher standards, the model to follow is the German Augen Optikmeister model, where opticians can refract. This might work in some US states, especially those with a strong medical optometry trend, which goes hand in hand with optometrists no longer wanting to refract.


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