DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part of
the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of
the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Hoffmann HB No. 527
Abstract: Provides relative to the practice of optometry.
Present law (R.S. 37:1041(C)(2)(a)) defines "diagnostic and therapeutic pharmaceutical agent"
as meaning any chemical in solution, suspension, emulsion, ointment base, or other form that
when used topically or orally has the property of assisting in the diagnosis, prevention, treatment,
or mitigation of abnormal conditions and pathology of the human eye and its adnexa, or those
which may be used for such purposes, and certain approved narcotics, when used in treatment of
disorders or diseases of the eye and its adnexa.
Proposed law modifies the definition of "diagnostic and therapeutic pharmaceutical agent" to
mean any prescription or nonprescription drug delivered by any route of administration used or
prescribed for the diagnosis, prevention, treatment, or mitigation of abnormal conditions and
pathology of the human eye and its adnexa, including controlled substances in Schedule III, IV,
and V of the Uniform Controlled Substances Law and hydrocodone combination drugs.
Present law (R.S. 37:1041(C)(2)(b)) specifies that "diagnostic and therapeutic pharmaceutical
agent" as defined in present law listed in Schedules III, IV, and V of the Uniform Controlled
Dangerous Substances Law is limited to use or to be prescribed by a licensed optometrist for a
maximum of 48 hours when used in treatment of disorders or diseases of the eye and its adnexa.
Proposed law repeals present law in its entirety.
Present law (R.S. 37:1041(C)(2)(c)) specifies that "diagnostic and therapeutic pharmaceutical
agent" does not include any drug or other substance listed in certain schedules of the Uniform
Controlled Dangerous Substances Law which is prohibited from use by a licensed optometrist.
Proposed law establishes an exception to present law which allows a licensed optometrist to use
hydrocodone combination drugs.
Present law (R.S. 37:1041(C)(2)(d)) authorizes a licensed optometrist to prescribe one additional
48-hour prescription if warranted by a follow-up exam.
Proposed law repeals present law in its entirety.
Present law (R.S. 37:1041(C)(3)) defines "licensed optometrist" as meaning a person licensed
and holding a certificate issued under the provisions of present law. Proposed law modifies present law by specifying that a "licensed optometrist" is a person who is
an optometric physician, in addition to being licensed and holding a certain certificate.
Present law (R.S. 37:1041(C)(4)(a)) defines "ophthalmic surgery" as meaning a procedure upon
the human eye or its adnexa in which in vivo human tissue is injected, cut, burned, frozen,
sutured, vaporized, coagulated, or photodisrupted by the use of surgical instrumentation such as,
but not limited to a scalpel, cryoprobe, laser, electric cautery, or ionizing radiation. Specifies that
nothing in present law limits an optometrist's ability to use diagnostic instruments utilizing laser
or ultrasound technology in the performance of primary eye care. Further, specifies that only
persons licensed to practice medicine by the La. State Board of Medical Examiners under the
laws of this state may perform ophthalmic surgery.
Proposed law specifies that present law does not limit an optometrist's ability to perform
ophthalmic surgery except those procedures excluded from the scope of practice in proposed law.
Present law (R.S. 37:1041(C)(5)) defines "optometry" as meaning a practice in which a person
employs primary eye care procedures or applies any means other than ophthalmic surgery, for the
measurement of the powers and testing the range of vision of the human eye, and determines its
accommodative and refractive state; general scope of function; and the adaptation, sale, and
dispensing of frames and lenses in all their forms, including plano or zero power contact lenses,
to overcome errors of refraction and restore as near as possible, normal human vision, or for
orthotic, prosthetic, therapeutic, or cosmetic purposes with respect to contact lenses. Further,
provides that optometry includes the examination, diagnosis, and treatment, other than by
ophthalmic surgery of abnormal conditions and pathology of the human eye and its adnexa,
including the provision of and the prescription of diagnostic and therapeutic pharmaceutical
agents.
Proposed law clarifies the definition of "optometry" by specifying that it does not include those
procedures excluded by proposed law. Further specifies that "optometry" includes
measurements of the powers and range of vision of the human eye using subjective or objective
means, including the use of lenses and prisms before the eye and autorefractors or other
automated testing devices to determine its accommodative and refractive state and general scope
of function and the adaptation, sale, and dispensing of frames and lenses in all their forms,
including plano or zero power contact lenses, to overcome errors of refraction and restore as near
as possible, normal human vision, or for orthotic, prosthetic, therapeutic, or cosmetic purposes
with respect to contact lenses.
Also, specifies that optometry includes the examination, diagnosis, and treatment of abnormal
conditions and pathology of the human eye and its adnexa, including the use or prescription of
vision therapy, ocular exercises, rehabilitation, ordering of appropriate diagnostic lab or imaging
tests; the dispensing of samples to initiate treatment and the use or prescription of diagnostic and
therapeutic pharmaceutical agents.
Proposed law (R.S. 37:1041(C)(6)) specifies that the following ophthalmic surgery procedures
are excluded from the scope of practice of optometry, except for the preoperative and postoperative care of these procedures:
(1)Retina laser procedures, Laser-Assisted In Situ Keratomileus (LASIK) and
Photorefractive Keratectomy (PRK).
(2)Penetrating keratoplasty (corneal transplant) or lamellar keratoplasty.
(3)The administration of general anesthesia.
(4)Laser or nonlaser injection into the vitreous chamber of the eye to treat any macular or
retinal disease.
(5)The following nonlaser surgical procedures:
(a)Surgery related to removal of the eye from a living human being.
(b)Surgery requiring full thickness incision or excision of the cornea or sclera other
than paracentesis in an emergency situation requiring immediate reduction of the
pressure inside the eye.
(c)Surgery requiring incision of the iris and ciliary body, including iris diathermy or
cryotherapy.
(d)Surgery requiring incision of the vitreous.
(e)Surgery requiring incision of the retina.
(f)Surgical extraction of the crystalline lens.
(g)Surgical intraocular implants.
(h)Incisional or excisional surgery of the extraocular muscles.
(i)Surgery of the eyelid for suspect eyelid malignancies or for incisional cosmetic or
mechanical repair of blepharochalasis, ptosis, and tarsorrhapy.
(j)Surgery of the bony orbit, including orbital implants.
(k)Incisional or excisional surgery of the lacrimal system other than lacrimal probing
or related procedures.
(l)Surgery requiring full thickness conjunctivoplasty with graft or flap.
(m)Any surgical procedure that does not provide for the correction and relief of
ocular abnormalities.
Proposed law (R.S. 37:1041(D)) specifies that in a public health emergency, the La. State Health
Officer may authorize therapeutically licensed optometrists to administer inoculations for
systemic health reasons.
Present law (R.S. 37:1048) establishes the responsibilities and powers of the board relative to the
regulation of the practice of optometry.
Proposed law (R.S. 37:1048(15), (16), and (17)) adds the following responsibilities:
(1)Any therapeutically licensed optometrist authorized to practice pursuant to present law
must meet the educational and competence criteria set forth by the board in order to perform expanded therapeutic procedures. Evidence of proof of continuing competency
must be determined by the board.
(2)Nothing in present law can be construed as allowing any agency, board, or other entity of
this state other than the La. State Board of Optometry Examiners to determine what
constitutes the practice of optometry.
(3)The board has the sole authority to determine what constitutes the practice of optometry
and sole jurisdiction to exercise any other powers and duties under present law.
Authorizes the board to issue advisory opinions and declaratory rulings related to present
law and the administrative regulations promulgated pursuant to present law.
Present law (R.S. 37:1049) establishes the qualifications and requirements for applicants desiring
to become licensed to practice optometry.
Proposed law adds a requirement that applicants meet the credentialing requirements of the board
to perform authorized ophthalmic surgery procedures.
Present law (R.S. 37:1061(A)(29)) authorizes the board to assess a fine, not more than $5,000,
for each offense, refuse to license, register, certify, or permit any applicant, refuse to renew the
license or permit of any person, or revoke, summarily suspend, suspend, place on probation,
reprimand, issue a warning against the person who was issued the license, registration,
certificate, permit, or any other designation deemed necessary to engage in the practice of
optometry upon proof that the person practiced medicine or surgery for the use of carrying on the
practice of optometry. Specifies that present law does not prevent the possession or use of ocular
diagnostic and therapeutic pharmaceutical agents by a licensed optometrist as long as that
person's conduct is in accordance with the provisions of present law. Proposed law repeals present law in its entirety.
(Amends R.S. 37:1041(C)(2)(a) and (c), and (3), (4)(a), and (5); Adds R.S. 37:1041(C)(6) and
(D), 1048(15), (16), and (17), and 1049(8); Repeals R.S. 37:1041(C)(2)(b) and (d) and
1061(A)(29))