HLS 13RS-351 ENGROSSED
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Regular Session, 2013
HOUSE BILL NO. 527
BY REPRESENTATIVES HOFFMANN, ANDERS, BARROW, BERTHELOT,
BROADWATER, HAZEL, HENSGENS, HILL, HODGES, KATRINA JACKSON,
LEBAS, MACK, POPE, PUGH, REYNOLDS, ST. GERMAIN, AND WILLMOTT
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
OPTOMETRISTS: Provides relative to the practice of optometry and the regulation of such
profession
AN ACT1
To amend and reenact R.S. 37:1041(C)(2)(a) and (c), (3), (4)(a), and (5), to enact R.S.2
37:1041(C)(6) and (D), 1048(15), (16), and (17), and 1049(8), and to repeal R.S.3
37:1041(C)(2)(b) and (d) and 1061(A)(29), relative to the practice of optometry; to4
provide definitions; to provide for the powers of the board in the control and5
regulation of the practice of optometry; to provide for the qualifications and6
requirements of applicants desiring to become licensed to practice optometry; and7
to provide for related matters.8
Be it enacted by the Legislature of Louisiana:9
Section 1. R.S. 37:1041(C)(2)(a) and (c), (3), (4)(a), and (5) are hereby amended and10
reenacted and R.S. 37:1041(C)(6) and (D), 1048(15), (16), and (17), and 1049(8) are hereby11
enacted to read as follows:12
§1041. Legislative declaration; statement of purpose; definitions13
* * *14
C. As used in this Chapter, the following terms have the meaning ascribed15
to them in this Section, unless the context clearly indicates otherwise:16
* * *17 HLS 13RS-351 ENGROSSED
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(2)(a) "Diagnostic and therapeutic pharmaceutical agent" means any1
chemical in solution, suspension, emulsion, ointment base, or other form that when2
used topically or orally has the property of assisting in prescription or3
nonprescription drug delivered by any route of administration, used or prescribed for4
the diagnosis, prevention, treatment, or mitigation of abnormal conditions and5
pathology of the human eye and its adnexa, or those which may be used for such6
purposes, and including certain approved narcotics, when used in treatment of7
disorders or diseases of the eye and its adnexa controlled substances in Schedule III,8
IV, and V of the Uniform Controlled Substances Law and hydrocodone combination9
drugs.10
* * *11
(c) "Diagnostic and therapeutic pharmaceutical agent" shall not include any12
drug or other substance listed in Schedules I and II of the Uniform Controlled13
Dangerous Substances Law provided in R.S. 40:963 and 964 which shall be14
prohibited from use by a licensed optometrist, except for hydrocodone combination15
drugs.16
* * *17
(3) "Licensed optometrist" means a person who is an optometric physician18
licensed and holding a certificate issued under the provisions of this Chapter.19
(4)(a) "Ophthalmic surgery" means a procedure upon the human eye or its20
adnexa in which in vivo human tissue is injected, cut, burned, frozen, sutured,21
vaporized, coagulated, or photodisrupted by the use of surgical instrumentation such22
as, but not limited to a scalpel, cryoprobe, laser, electric cautery, or ionizing23
radiation. Nothing in this Chapter shall limit an optometrist's ability to use24
diagnostic instruments utilizing laser or ultrasound technology in the performance25
of primary eye care or limit an optometrist's ability to perform ophthalmic surgery26
except for those procedures excluded in Paragraph (6) of this Subsection. Only27
persons licensed to practice medicine by the Louisiana State Board of Medical28 HLS 13RS-351 ENGROSSED
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Examiners under the laws of this state may perform ophthalmic surgery procedures1
listed in Paragraph (6) of this Subsection.2
* * *3
(5) "Optometry" means that practice in which a person employs primary eye4
care procedures or applies any means other than including ophthalmic surgery,5
except those procedures specifically excluded in Paragraph (6) of this Subsection;6
for the measurement of measures the powers and testing the range of vision of the7
human eye using subjective or objective means, including the use of lenses and8
prisms before the eye and autorefractors or other automated testing devices to, and9
determines determine its accommodative and refractive state, and general scope of10
function,; and the adaptation, sale, and dispensing of frames and lenses in all their11
forms, including plano or zero power contact lenses, to overcome errors of refraction12
and restore as near as possible, normal human vision, or for orthotic, prosthetic,13
therapeutic, or cosmetic purposes with respect to contact lenses. Optometry also14
includes the examination, diagnosis, and treatment, other than by ophthalmic surgery15
of abnormal conditions and pathology of the human eye and its adnexa, including the16
use or prescription provision of vision therapy, ocular exercises, rehabilitation17
therapy, ordering of appropriate diagnostic lab or imaging tests; the dispensing of18
samples to initiate treatment;, use, and the use or prescription of diagnostic and19
therapeutic pharmaceutical agents. With respect to frames and lenses, including20
those containing diagnostic and therapeutic pharmaceutical agents, an optometrist21
may provide samples or dispense such products to his own patients, provided22
however that such dispensing activities shall conform to rules relative to packaging,23
labeling, and record keeping recordkeeping promulgated by the board.24
(6) The following ophthalmic surgery procedures are excluded from the25
scope of practice of optometry, except for the preoperative and postoperative care26
of these procedures:27 HLS 13RS-351 ENGROSSED
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(a) Retina laser procedures, Laser-Assisted In Situ Keratomileus (LASIK)1
and Photorefractive Keratectomy (PRK).2
(b) Penetrating keratoplasty (corneal transplant) or lamellar keratoplasty.3
(c) The administration of general anesthesia.4
(d) Laser or nonlaser injection into the vitreous chamber of the eye to treat5
any macular or retinal disease.6
(e) The following nonlaser surgical procedures:7
(i) Surgery related to removal of the eye from a living human being.8
(ii) Surgery requiring full thickness incision or excision of the cornea or9
sclera other than paracentesis in an emergency situation requiring immediate10
reduction of the pressure inside the eye.11
(iii) Surgery requiring incision of the iris and ciliary body, including iris12
diathermy or cryotherapy.13
(iv) Surgery requiring incision of the vitreous.14
(v) Surgery requiring incision of the retina.15
(vi) Surgical extraction of the crystalline lens.16
(vii) Surgical intraocular implants.17
(viii) Incisional or excisional surgery of the extraocular muscles.18
(ix) Surgery of the eyelid for suspect eyelid malignancies or for incisional19
cosmetic or mechanical repair of blepharochalasis, ptosis, and tarsorrhaphy.20
(x) Surgery of the bony orbit, including orbital implants. 21
(xi) Incisional or excisional surgery of the lacrimal system other than22
lacrimal probing or related procedures.23
(xii) Surgery requiring full thickness conjunctivoplasty with graft or flap.24
(xiii) Any surgical procedure that does not provide for the correction and25
relief of ocular abnormalities. 26 HLS 13RS-351 ENGROSSED
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D. In a public health emergency, the Louisiana State Health Officer may1
authorize therapeutically licensed optometrists to administer inoculations for2
systemic health reasons. 3
* * *4
§1048. Powers of the board5
The board shall be responsible for the control and regulation of the practice6
of optometry and may:7
* * *8
(15) Any therapeutically licensed optometrist authorized to practice pursuant9
to this Chapter shall meet the educational and competence criteria established by the10
board in order to perform expanded therapeutic procedures. Evidence of proof of11
continuing competency shall be determined by the board.12
(16) Nothing in this Chapter shall be construed as allowing any agency,13
board, or other entity of this state other than the Louisiana State Board of Optometry14
Examiners to determine what constitutes the practice of optometry. 15
(17) The board shall have the sole authority to determine what constitutes16
the practice of optometry and sole jurisdiction to exercise any other powers and17
duties provided in this Chapter. The board may issue advisory opinions and18
declaratory rulings related to this Chapter and the administrative regulations19
promulgated pursuant to this Chapter.20
§1049. Qualifications and requirements of applicants21
All persons desiring to become licensed to practice optometry shall:22
* * *23
(8) Meet the credentialing requirements of the board to perform authorized24
ophthalmic surgery procedures. 25
Section 2. R.S. 37:1041(C)(2)(b) and (d) and 1061(A)(29) are hereby repealed in26
their entirety.27 HLS 13RS-351 ENGROSSED
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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 HLS 13RS-351 ENGROSSED
HB NO. 527
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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. HLS 13RS-351 ENGROSSED
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(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. HLS 13RS-351 ENGROSSED
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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))