OPTOMETRIC PRACTICE AND LICENSURE ACT - AMEND PHARMACEUTICAL AGENT
          REQUIREMENTS FOR GLAUCOMA TREATMENT AND DRUG APPROVAL
                 Act of Dec. 16, 2002, P.L. 1950, No. 225             Cl. 63
                             Session of 2002
                               No. 2002-225

     SB 831

                                  AN ACT

     Amending the act of June 6, 1980 (P.L.197, No.57), entitled "An
        act regulating the licensure and practice of optometry,
        making repeals and providing penalties," further defining
        "examination and diagnosis" and "practice of optometry"; and
        providing for requirements concerning pharmaceutical agents
        for the treatment of glaucoma and for approval of drugs.

        The General Assembly of the Commonwealth of Pennsylvania
     hereby enacts as follows:

        Section 1.  The definitions of "examination and diagnosis"
     and "practice of optometry" in section 2 of the act of June 6,
     1980 (P.L.197, No.57), known as the Optometric Practice and
     Licensure Act, amended October 30, 1996 (P.L.721, No.130), are
     amended to read:
      Section 2.  Definitions.
        The following words and phrases when used in this act shall
     have, unless the context clearly indicates otherwise, the
     meanings given to them in this section:
        * * *
        "Examination and diagnosis."  Any examination or diagnostic
     means or method compatible with optometric education and
     professional competence. The term shall encompass the use of
     pharmaceutical agents for diagnostic purposes classified as
     miotics, mydriatics, cycloplegics, topical anesthetics and dyes
     when applied topically to the eye, which pharmaceutical agents
     shall be approved by the Secretary of Health as provided in
     section 4.3 and, subject to the rules and regulations of the
     board, provided however that with respect to optometrists
     licensed before March 1, 1974, only such optometrists who have
     satisfactorily completed a course in pharmacology as it applies
     to optometry, with particular emphasis on the topical
     application of diagnostic pharmaceutical agents to the eye,
     approved by the board shall be permitted to use diagnostic
     pharmaceutical agents topically in the practice of optometry.
        * * *
        "Practice of optometry."
            (1)  The use of any and all means or methods for the
        examination, diagnosis and treatment of conditions of the
        human visual system and shall include the examination for,
        and adapting and fitting of, any and all kinds and types of
        lenses including contact lenses.
            (2)  The administration and prescription of legend and
        nonlegend drugs as approved by the Secretary of Health as
        provided in section 4.3 for treatment of the [anterior
        segment of the] eye, the eyelids, the lacrimal system and the
        conjunctiva and the removal of superficial foreign bodies
        from the ocular surface and adnexa so long as treatment of
        diseases or conditions of the visual system, other than
        glaucoma, as authorized under this paragraph shall not
        continue beyond six weeks from the initiation of treatment
        unless the prescribing optometrist documents consultation
        with a licensed physician. As used in this paragraph, the
        initiation of treatment may, but need not, include the
        prescription or administration of pharmaceutical agents for
        therapeutic purposes.
            (3)  The term shall not include:
                (i)  surgery, including, but not limited to, laser
            surgery; the use of lasers for therapeutic purposes; and
            the use of injections in the treatment of ocular disease;
                (ii)  the use of Schedule I and Schedule II
            controlled substances;
                [(iii)  the use of beta blockers and the use of
            steroids;
                (iv)  treatment of systemic disease; and
                (v)  the treatment of glaucoma.]
                (iii)  treatment of systemic disease; and
                (iv)  the treatment of glaucoma, except that
            optometrists may use all topical pharmaceutical agents in
            the treatment of primary open angle glaucoma, exfoliation
            glaucoma and pigmentary glaucoma.
        * * *
        Section 2.  The act is amended by adding sections to read:
      Section 4.2.  Additional requirements to prescribe and
                    administer pharmaceutical agents for the
                    treatment of certain types of glaucoma.
        (a)  Prior to treating glaucoma for the first time, all
     therapeutically certified optometrists must have passed an
     examination that included prescription and administration of
     pharmaceutical agents for therapeutic purposes as required in
     section 4.1(a). Therapeutically certified optometrists who
     passed the examination under section 4.1(a)(2) shall also
     complete at least 18 hours of continuing education in glaucoma.
     In order to continue treating glaucoma, the therapeutically
     certified optometrist shall, as part of the continuing education
     required for renewal of a license under this act, complete at
     least four hours in the study of the prescription and
     administration of pharmaceutical agents for the treatment of
     glaucoma.
        (b)  Therapeutically certified optometrists who prescribe and
     administer pharmaceutical agents for the treatment of glaucoma
     permitted under this act shall obtain and maintain professional
     liability insurance in accordance with section 3(a)(2.5), except
     that the amount of professional liability insurance maintained
     shall be a minimum of $1,000,000 per occurrence and $3,000,000
     per annual aggregate.
      Section 4.3.  Approval of drugs.
        Drugs shall be approved as follows:
            (1)  All drugs currently approved by the Secretary of
        Health and in use in the practice of optometry on the
        effective date of this section shall be deemed approved under
        this section.
            (2)  Within 90 days of the effective date of this
        section, the board shall submit a list of drugs authorized
        under this act to the Secretary of Health, who, in
        consultation with the Physician General, shall approve or
        disapprove for good cause each drug. Upon failure of the
        Secretary of Health to act within 90 days of receipt of the
        list of drugs, the drugs shall be deemed approved for use
        under this act.
            (3)  The State Board of Optometry shall provide the
        Secretary of Health with lists of additional drugs for use
        under this act after such drugs are approved by the Food and
        Drug Administration, as published in the Code of Federal
        Regulations. The Secretary of Health, in consultation with
        the Physician General, shall approve or disapprove for good
        cause any such drug within 90 days of the receipt of the
        list. Upon failure of the Secretary of Health to act within
        90 days, the drugs shall be deemed approved for use under
        this act.
        Section 3.  Section 8(a) of the act is amended by adding a
     paragraph to read:
      Section 8.  Violations and penalties.
        (a) * * *
            (3)  It is unlawful for optometrists to hold themselves
        out as performing laser surgery or using therapeutic lasers.
        * * *
        Section 4.  This act shall take effect immediately.

     APPROVED--The 16th day of December, A. D. 2002.

     MARK S. SCHWEIKER