Brief Description: Authorizing optometrists to use and prescribe approved drugs for diagnostic or therapeutic purposes without limitation upon the methods of delivery in the practice of optometry.

Sponsors: Representatives Kessler, Pflug, Ruderman, Alexander, Cody, Moeller, Campbell, Clibborn, Morrell, Armstrong, Clements, Delvin, McDonald, Berkey, Haigh, Kenney, Hankins, Conway, Rockefeller, Simpson, Chase and McMahan.

Hearing Date: 1/28/03

Staff: Chris Blake (786-7392).

Background:

Optometry

The practice of optometry involves the examination of the human eye, the examination and ascertaining of any defects of the human vision system, and the analysis of the process of vision. Optometrists may test patients' visual acuity, depth and color perception, and the ability to focus and coordinate the eyes; prescribe eyeglasses and contact lenses; prescribe visual therapy; and adapt prosthetic eyes.

Upon meeting additional requirements, optometrists may also prescribe topically applied drugs for diagnostic or therapeutic purposes. They may apply topical drugs for diagnostic purposes upon (1) completing 60 hours of didactic and clinical instruction in general and ocular pharmacology and (2) receiving certification from an accredited institute of higher education. Optometrists may prescribe topical drugs for therapeutic purposes upon (1) completing the requirements for diagnostic drugs; (2) completing an additional 75 hours of didactic and clinical instruction in ocular pharmacology, anti-infective drugs, and anti-inflammatory drugs; and (3) receiving certification from an accredited institute of higher education.

Optometrists are regulated by the Optometry Board (Board) under the Uniform Disciplinary Act. The Board is responsible for the issuance and denial of provider licenses, the investigation of acts of unprofessional conduct, and the discipline of licensees. The Board has also adopted a drug formulary of topically applied diagnostic and therapeutic drugs that optometrists may use upon meeting the additional training requirements.

Controlled Substances

Controlled substances are categorized into five types according to their potential for abuse, the extent of currently accepted medical use in the United States, and the potential that use of the drug may lead to physical or psychological dependence. Schedule I drugs are those drugs with a high potential for abuse, no currently accepted medical use in treatment, and a lack of accepted safety for use in treatment under medical supervision. At the other end of the spectrum are Schedule V drugs which are those drugs with a low potential for abuse relative to the other categories, a currently accepted medical use in treatment, and a likelihood that abuse may lead to only limited physical or psychological dependence relative to the other categories.

Summary of Bill:

The range of drugs that an optometrist may use or prescribe is expanded beyond certain topically-applied drugs to include some oral drugs for diagnostic and therapeutic purposes and injectable epinephrine for the treatment of anaphylactic shock. Optometrists may only prescribe or administer drugs that treat diseases or conditions of the eye and adnexa that are within an optometrist's scope of practice.

To use or prescribe therapeutic oral medications, an optometrist must: (1) meet the existing supplemental requirements for topically-applied drugs; (2) complete an additional 16 hours of didactic instruction and eight hours of supervised clinical instruction; and (3) receive certification from an accredited institute of higher education.

To use injectable epinephrine, an optometrist must: (1) meet the existing supplemental requirements for topically-applied drugs; (2) complete an additional four hours of didactic and supervised clinical instruction; and (3) receive certification from an accredited institute of higher education.

The Optometry Board must consult with the Board of Pharmacy to create a list of Schedule III, IV, and V controlled substances that optometrists may prescribe. The two boards must also develop rules to specify the proper dosages and forms of the drugs that optometrists may prescribe or administer.

Optometrists may not prescribe a controlled substance for more than seven days to any patient for treating a single episode or condition or for pain.

Optometrists may not perform retinal repair surgery or laser in situ keratomileusis surgery or prescribe any Schedule I substance.

Technical corrections are made to other statutory sections to reflect these changes.

Appropriation: None.

Fiscal Note: Requested on January 21, 2003.

Effective Date: Ninety days after adjournment of session in which bill is passed.