By Coleman H.B. No. 2091
75R7441 JMM-F
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of the practice of therapeutic
1-3 optometry.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Sections 1.02(7) and (8), Texas Optometry Act
1-6 (Article 4552-1.02, Vernon's Texas Civil Statutes), are amended to
1-7 read as follows:
1-8 (7) The "practice of therapeutic optometry" means the
1-9 employment of objective or subjective means for the purpose of
1-10 ascertaining and measuring the powers of vision of the human eye,
1-11 examining and diagnosing visual defects, abnormal conditions, and
1-12 diseases of the human eye and adnexa, prescribing or fitting lenses
1-13 or prisms to correct or remedy a defect or abnormal condition of
1-14 vision, administering or prescribing a drug or physical treatment
1-15 in the manner authorized by this Act, and treating the visual
1-16 system, including the eye and adnexa as authorized by this Act
1-17 [without the use of surgery or laser surgery]. The practice of
1-18 therapeutic optometry does not include the use of surgery or laser
1-19 surgery except as specifically authorized by this Act.
1-20 (8) "Adnexa" means the lids and drainage system of the
1-21 eye and related structures.
1-22 SECTION 2. Section 1.03, Texas Optometry Act (Article
1-23 4552-1.03, Vernon's Texas Civil Statutes), is amended by amending
1-24 Subsections (b) and (d)-(g) and adding Subsection (h) to read as
2-1 follows:
2-2 (b) A therapeutic optometrist may administer, perform, or
2-3 [and] prescribe ophthalmic devices, procedures, and appropriate
2-4 medications administered by [over-the-counter oral medications,
2-5 and] topical, oral, or parenteral means [ocular pharmaceutical
2-6 agents, other than antiviral agents and antiglaucoma agents,] for
2-7 the purpose of diagnosing and treating visual defects, abnormal
2-8 conditions, and diseases of the human vision system, including the
2-9 eye and adnexa [and may remove superficial foreign matter and
2-10 eyelashes from the external eye or adnexa. If a therapeutic
2-11 optometrist utilizes topical steroids of a strength of one percent
2-12 concentration to treat a condition and the condition has not
2-13 substantially improved within seven days of the initial topical
2-14 steroid application, the therapeutic optometrist shall consult with
2-15 an ophthalmologist and the ophthalmologist shall then establish the
2-16 treatment regimen. If a therapeutic optometrist utilizes topical
2-17 steroids of a strength of less than one percent concentration to
2-18 treat a condition and the condition has not substantially improved
2-19 within 14 days of the initial topical steroid application, the
2-20 therapeutic optometrist shall consult with an ophthalmologist and
2-21 the ophthalmologist shall then establish the treatment regimen.
2-22 This subsection does not authorize an optometrist to treat glaucoma
2-23 in a manner that was not permitted by law on August 31, 1991].
2-24 (d) The board shall adopt rules setting forth the specific
2-25 classifications of pharmaceutical agents therapeutic optometrists
2-26 may use in the practice of therapeutic optometry. Use by a
2-27 therapeutic optometrist of pharmaceutical agents not authorized by
3-1 the board or otherwise authorized by law shall constitute a
3-2 violation of this Act.
3-3 (e) [A five-member technical advisory committee is created
3-4 to assist the board in determining the specific pharmaceutical
3-5 agents which may be used in the practice of therapeutic optometry.
3-6 Appointments to the committee shall be for two-year terms, and no
3-7 member may serve more than two consecutive terms.]
3-8 [(f) The members of the technical advisory committee shall
3-9 be appointed as follows: one must be an optometrist or therapeutic
3-10 optometrist licensed and practicing in this state, appointed by the
3-11 Texas Optometry Board; one must be a physician licensed and
3-12 practicing in this state whose practice is limited to
3-13 ophthalmology, appointed by the Texas State Board of Medical
3-14 Examiners; one must be a pharmacist licensed and practicing
3-15 pharmacy in this state, appointed by the Texas State Board of
3-16 Pharmacy; one must be a faculty member at a state medical
3-17 institution of higher education with expertise in pharmacology,
3-18 appointed by the Texas State Board of Medical Examiners; and one
3-19 must be a faculty member of a college of optometry at a state
3-20 institution of higher education, appointed by the Texas Optometry
3-21 Board.]
3-22 [(g)] A therapeutic optometrist is subject to the same
3-23 standard of professional care and judgment as a person practicing
3-24 as an ophthalmologist under the Medical Practice Act (Article
3-25 4495b, Vernon's Texas Civil Statutes).
3-26 (f) A therapeutic optometrist may not perform surgery
3-27 unless:
4-1 (1) the board has established the educational
4-2 standards and the credentials required to perform the particular
4-3 surgical procedure; and
4-4 (2) the therapeutic optometrist has met the
4-5 requirements established by the board for the procedure.
4-6 (g) A therapeutic optometrist may not perform cataract
4-7 surgery or other open globe surgery. For the purposes of this
4-8 subsection, "open globe surgery" means a surgical procedure that
4-9 opens the globe of the eye and exposes an internal chamber of the
4-10 eye to the outside atmosphere.
4-11 (h) A therapeutic optometrist may not perform radial
4-12 keratotomy surgery.
4-13 SECTION 3. Article 1, Texas Optometry Act (Article 4552-1.01
4-14 et seq., Vernon's Texas Civil Statutes), is amended by adding
4-15 Section 1.04 to read as follows:
4-16 Sec. 1.04. STUDY REGARDING LASER SURGERY. (a) The
4-17 University of Houston College of Optometry shall conduct a study
4-18 analyzing the safety, efficacy, and cost-effectiveness of laser
4-19 surgery performed by therapeutic optometrists.
4-20 (b) A therapeutic optometrist may not perform laser surgery
4-21 except under the direct supervision of an ophthalmologist as part
4-22 of the study conducted by the University of Houston College of
4-23 Optometry under this section.
4-24 (c) The University of Houston College of Optometry shall
4-25 submit to the presiding officer of each house of the legislature
4-26 not later than January 1 of each year a written report that
4-27 evaluates the safety, efficacy, and cost-effectiveness of laser
5-1 surgery performed by therapeutic optometrists.
5-2 SECTION 4. The importance of this legislation and the
5-3 crowded condition of the calendars in both houses create an
5-4 emergency and an imperative public necessity that the
5-5 constitutional rule requiring bills to be read on three several
5-6 days in each house be suspended, and this rule is hereby suspended,
5-7 and that this Act take effect and be in force from and after its
5-8 passage, and it is so enacted.