By: Ratliff S.B. No. 624
97S0438/1
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the regulation of therapeutic optometry.
1-2 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-3 SECTION 1. Subdivisions (7) and (8), Section 1.02, Texas
1-4 Optometry Act (Article 4552-1.02, Vernon's Texas Civil Statutes),
1-5 are amended to read as follows:
1-6 (7) The "practice of therapeutic optometry" means the
1-7 employment of objective or subjective means for the purpose of
1-8 ascertaining and measuring the powers of vision of the human eye,
1-9 examining and diagnosing visual defects, abnormal conditions, and
1-10 diseases of the human eye and adnexa, prescribing or fitting lenses
1-11 or prisms to correct or remedy a defect or abnormal condition of
1-12 vision, administering or prescribing a drug or physical treatment
1-13 in the manner authorized by this Act, and treating the visual
1-14 system, including the eye and adnexa, as authorized by this Act
1-15 [without the use of surgery or laser surgery]. The practice of
1-16 therapeutic optometry does not include the use of surgery or laser
1-17 surgery except as specifically authorized by Section 1.03(f) of
1-18 this Act.
1-19 (8) "Adnexa" means the lids and drainage system of the
1-20 eye and related structures.
1-21 SECTION 2. Section 1.03, Texas Optometry Act (Article
1-22 4552-1.03, Vernon's Texas Civil Statutes), is amended to read as
1-23 follows:
2-1 Sec. 1.03. THERAPEUTIC OPTOMETRISTS. (a) A person may not
2-2 engage in the practice of therapeutic optometry without holding a
2-3 license issued by the Texas Optometry Board.
2-4 (b) A therapeutic optometrist may administer, perform, or
2-5 [and] prescribe ophthalmic devices, procedures, and appropriate
2-6 medications administered by topical, oral, or parenteral means
2-7 [over-the-counter oral medications, and topical ocular
2-8 pharmaceutical agents, other than antiviral agents and antiglaucoma
2-9 agents,] for the purpose of diagnosing and treating visual defects,
2-10 abnormal conditions, and diseases of the human vision system,
2-11 including the eye and adnexa [and may remove superficial foreign
2-12 matter and eyelashes from the external eye or adnexa. If a
2-13 therapeutic optometrist utilizes topical steroids of a strength of
2-14 one percent concentration to treat a condition and the condition
2-15 has not substantially improved within seven days of the initial
2-16 topical steroid application, the therapeutic optometrist shall
2-17 consult with an ophthalmologist and the ophthalmologist shall then
2-18 establish the treatment regimen. If a therapeutic optometrist
2-19 utilizes topical steroids of a strength of less than one percent
2-20 concentration to treat a condition and the condition has not
2-21 substantially improved within 14 days of the initial topical
2-22 steroid application, the therapeutic optometrist shall consult with
2-23 an ophthalmologist and the ophthalmologist shall then establish the
2-24 treatment regimen. This subsection does not authorize an
2-25 optometrist to treat glaucoma in a manner that was not permitted by
3-1 law on August 31, 1991].
3-2 (c) A therapeutic optometrist must satisfactorily complete
3-3 the educational requirements established by board rule to be
3-4 certified as a therapeutic optometrist. These educational
3-5 requirements must be provided by an entity approved by the board
3-6 and must include an emphasis on the examination, diagnosis, and
3-7 treatment of conditions of the human eye and adnexa. The board by
3-8 rule shall require successful completion of accredited academic and
3-9 clinical courses in pharmacology and related pathology that are
3-10 approved by the board and that are determined by the board to be
3-11 equivalent in the total number of classroom hours to the
3-12 requirements for other health care professionals in this state who
3-13 may be licensed to use pharmaceutical agents, including dentists,
3-14 podiatrists, and physicians.
3-15 (d) The board shall adopt rules setting forth the specific
3-16 classifications of pharmaceutical agents therapeutic optometrists
3-17 may use in the practice of therapeutic optometry. Use by a
3-18 therapeutic optometrist of pharmaceutical agents not authorized by
3-19 the board or otherwise authorized by law shall constitute a
3-20 violation of this Act.
3-21 (e) [A five-member technical advisory committee is created
3-22 to assist the board in determining the specific pharmaceutical
3-23 agents which may be used in the practice of therapeutic optometry.
3-24 Appointments to the committee shall be for two-year terms, and no
3-25 member may serve more than two consecutive terms.]
4-1 [(f) The members of the technical advisory committee shall
4-2 be appointed as follows: one must be an optometrist or therapeutic
4-3 optometrist licensed and practicing in this state, appointed by the
4-4 Texas Optometry Board; one must be a physician licensed and
4-5 practicing in this state whose practice is limited to
4-6 ophthalmology, appointed by the Texas State Board of Medical
4-7 Examiners; one must be a pharmacist licensed and practicing
4-8 pharmacy in this state, appointed by the Texas State Board of
4-9 Pharmacy; one must be a faculty member at a state medical
4-10 institution of higher education with expertise in pharmacology,
4-11 appointed by the Texas State Board of Medical Examiners; and one
4-12 must be a faculty member of a college of optometry at a state
4-13 institution of higher education, appointed by the Texas Optometry
4-14 Board.]
4-15 [(g)] A therapeutic optometrist is subject to the same
4-16 standard of professional care and judgment as a person practicing
4-17 as an ophthalmologist under the Medical Practice Act (Article
4-18 4495b, Vernon's Texas Civil Statutes).
4-19 (f) The following surgical procedures may be performed by a
4-20 therapeutic optometrist:
4-21 (1) removal of superficial foreign bodies from the
4-22 external eye or adnexa;
4-23 (2) repair of superficial wounds of the external eye
4-24 or adnexa;
4-25 (3) removal or destruction of superficial lesions of
5-1 the external eye or adnexa;
5-2 (4) removal or drainage of chalazia or cysts of the
5-3 external eye or adnexa;
5-4 (5) removal or destruction of eyelashes, provided that
5-5 such procedure is performed without the use of lasers;
5-6 (6) closure of the lacrimal punctum, provided that
5-7 such procedure is performed without the use of lasers;
5-8 (7) dilation, irrigation, or probing of the lacrimal
5-9 system; and
5-10 (8) other procedures designed to treat superficial
5-11 conditions of the external eye or adnexa for which specific Current
5-12 Procedural Terminology (CPT) codes were not in existence on
5-13 January 1, 1997, and which are specifically authorized by rule of
5-14 the board.
5-15 SECTION 3. The importance of this legislation and the
5-16 crowded condition of the calendars in both houses create an
5-17 emergency and an imperative public necessity that the
5-18 constitutional rule requiring bills to be read on three several
5-19 days in each house be suspended, and this rule is hereby suspended,
5-20 and that this Act take effect and be in force from and after its
5-21 passage, and it is so enacted.