On February 5, 2026, the newly elected President of the Kentucky Board of Optometric Examiners (KBOE) issued a statement announcing a planned amendment to reverse last year’s weakening of its initial licensure regulations (at 201 KAR 5:010) and a planned filing of a new emergency regulation addressing requirements for continued practice of the individuals to whom the KBOE had granted invalid waivers of its licensing exam requirements. The statement also declared that the KBOE is “committed to protecting the public, maintaining transparency, and ensuring a consistent and accountable licensing process moving forward.” The new emergency regulation was filed on February 5th and by law is immediately in effect 1.
The National Board of Examiners in Optometry® (NBEO®) 2 commends the KBOE for taking steps to restore the public’s confidence in the competence of doctors of optometry who hold KBOE licenses to practice independently. These measures, however, continue to allow gaps in public protection, conceal relevant information from patients and the public, and prioritize continued exceptions for waived-in licensees over patient protection without adequate justification or rationale by the KBOE.
The KBOE Should Restore Kentucky’s Full NBEO Examination Requirements for All Licensed Optometrists, Not Just for Some
The process of obtaining a license to practice optometry entails determining whether a candidate has demonstrated the baseline qualifications of training, knowledge, and competencies to enter into independent practice. The scope of practice of U.S. optometrists overlaps with medical doctors, especially in Kentucky. Like MDs, ODs must practice to the medical standard of care. NBEO assesses candidates for the independent practice of optometry through a three-part licensure exam series that is designed to be parts of a whole, with each exam part measuring unique competencies that provide a comprehensive assessment of competency critical for entry into the profession of optometry. All three parts of the NBEO examination had been required by the KBOE’s initial licensure regulations, until last summer.
In brief, the NBEO Part I Applied Basic Science (ABS®) exam assesses whether optometry candidates demonstrate a baseline of biomedical science knowledge, with a particular focus on the eye and an optics section. NBEO Part I tests applied knowledge in areas like anatomy, physiology, optics, pathology, and pharmacology—critical for informed diagnostic and treatment decisions, as many optometry patients do not present as “textbook cases” or may have other health conditions that impact the safety and effectiveness of optometric eye care.
The NBEO Part II Patient Assessment and Management (PAM®) exam assesses candidates’ clinical thinking and decision-making, with a particularly heavy emphasis on diagnosis and treatment. It includes a section called the Treatment and Management of Ocular Disease (TMOD®) examination with an image-intensive, case-based format.
The NBEO Part III Patient Encounters and Performance Skills (PEPS®) exam is a simulated-live patient encounter examination. Candidates are expected to perform a focused case history, interpret and synthesize clinical data, and generate a management plan. Importantly for patient safety and proper treatment, candidates are also evaluated on their physical performance of essential optometric skills.
Last year, the KBOE amended its examination requirements to permit applicants for initial licensure to bypass the NBEO Part I examination. Instead, the KBOE’s current regulation allows optometry candidates to substitute a passing score on the Optometry Examining Board of Canada (OEBC) online exam, which is designed based on a different scope of practice in Canada and does not test the foundational biomedical science principles necessary for safe and skilled patient care as required in the United States.
NBEO agrees with the Kentucky Optometric Association that the KBOE’s decision to allow the Canadian exam as a substitute “cast doubt” on licensure standards in Kentucky 3.
The KBOE Should End Loopholes for Invalidly Waived-In Licensees and Restore Transparency for Kentucky Patients
As described in a prior statement by NBEO 4, the KBOE had voted on at least six dates during the period 2020-2023 to provide waivers of the then-applicable NBEO examination requirements to at least 21 optometry graduates who had not passed one or more parts of the NBEO examination at the time of their licensure.
The Kentucky Office of the Attorney General issued a formal opinion, OAG 25-13, on October 1, 2025 5. The opinion found that the KBOE had “acted beyond its authority in waiving licensure requirements” and that the waivers were “null, void, and unenforceable.”
NBEO also understands from news reports that the KBOE has refused requests by members of the public to identify all of the optometrists practicing in Kentucky who were granted waivers from regulatory exam requirements 6.
For these reasons, NBEO will be opposing the new emergency regulation. NBEO urges the KBOE to prioritize patient protection over special treatment of this cohort of individuals and to hold all Kentucky optometrists to the same competency standards.
For more information, contact NBEO at media@optometry.org.