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Regular Session, 2014
SENATE BILL NO. 509
BY SENATOR NEVERS
OPTOMETRISTS. Provides relative to the practice of optometry and the regulation of such
profession. (gov sig)
AN ACT1
To amend and reenact R.S. 37:1041(C)(2)(a), (3),(4)(a), and (5), to enact R.S. 37:1041(C)(6)2
and (D), 1048(15), (16), and (17), and 1049(8), and to repeal R.S. 37:1041(C)(2)(b)3
and (d) and 1061(A)(29), relative to the practice of optometry; to provide definitions;4
to provide for the powers of the board in the control and regulation of the practice5
of optometry; to provide for the qualifications and requirements of applicants6
desiring to become licensed to practice optometry; and to provide for related matters.7
Be it enacted by the Legislature of Louisiana:8
Section 1. R.S. 37:1041(C)(2)(a), (3), (4)(a), and (5) are hereby amended and9
reenacted, and R.S. 37:1041(C)(6) and (D), 1048(15), (16), and (17), and 1049(8) are hereby10
enacted to read as follows:11
§1041. Legislative declaration; statement of purpose; definitions12
* * *13
C. As used in this Chapter, the following terms have the meaning ascribed14
to them in this Section, unless the context clearly indicates otherwise:15
* * *16
(2)(a) "Diagnostic and therapeutic pharmaceutical agent" means any chemical17 SB NO. 509
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words in boldface type and underscored are additions.
in solution, suspension, emulsion, ointment base, or other form that when used1
topically or orally has the property of assisting in prescription or nonprescription2
drug delivered by any route of administration, used or prescribed for the3
diagnosis, prevention, treatment, or mitigation of abnormal conditions and pathology4
of the human eye and its adnexa, or those which may be used for such purposes, and5
certain approved narcotics, when used in treatment of disorders or diseases of the eye6
and its adnexa.7
* * *8
(3) "Licensed optometrist" means a person who is an optometric physician9
licensed and holding a certificate issued under the provisions of this Chapter.10
(4)(a) "Ophthalmic surgery" means a procedure upon the human eye or its11
adnexa in which in vivo human tissue is injected, cut, burned, frozen, sutured,12
vaporized, coagulated, or photodisrupted by the use of surgical instrumentation such13
as, but not limited to, a scalpel, cryoprobe, laser, electric cautery, or ionizing14
radiation. Nothing in this Chapter shall limit an optometrist's ability to use diagnostic15
or therapeutic instruments utilizing laser or ultrasound technology in the16
performance of primary eye care or limit an optometrist's ability to perform17
ophthalmic surgery except for those procedures excluded in Paragraph (6) of18
this Subsection. Only persons licensed to practice medicine by the Louisiana State19
Board of Medical Examiners under the laws of this state may perform ophthalmic20
surgery procedures listed in Paragraph (6) of this Subsection.21
* * *22
(5) "Optometry" means that practice in which a person employs primary eye23
care procedures or applies any means other than including ophthalmic surgery, for24
the measurement of except those procedures specifically excluded in Paragraph25
(6) of this Subsection; measures the powers and testing the range of vision of the26
human eye, and determines using subjective or objective means, including the use27
of lenses and prisms before the eye and autorefractors or other automated28
testing devices to determine its accommodative and refractive state, and general29 SB NO. 509
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scope of function,; and the adaptation, sale, and dispensing of frames and lenses in1
all their forms, including plano or zero power contact lenses, to overcome errors of2
refraction and restore as near as possible, normal human vision, or for orthotic,3
prosthetic, therapeutic, or cosmetic purposes with respect to contact lenses.4
Optometry also includes the examination, diagnosis, and treatment, other than by5
ophthalmic surgery of abnormal conditions and pathology of the human eye and its6
adnexa, including the provision use or prescription of vision therapy, ocular7
exercises, rehabilitation therapy, subnormal vision therapy, ordering of8
appropriate diagnostic lab or imaging tests; the dispensing of samples, use, to9
initiate treatment; and the use or prescription of diagnostic and therapeutic10
pharmaceutical agents. With respect to frames and lenses, including those containing11
diagnostic and therapeutic pharmaceutical agents, an optometrist may provide12
samples or dispense such products to his own patients, provided however that such13
dispensing activities shall conform to rules relative to packaging, labeling, and14
record keeping recordkeeping promulgated by the board.15
(6) The following ophthalmic surgery procedures are excluded from the16
scope of practice of optometry, except for the preoperative and postoperative17
care of these procedures:18
(a) Retina laser procedures, Laser-Assisted in situ Keratomileus19
(LASIK), Photorefractive Keratectomy (PRK), and any form of refractive20
surgery.21
(b) Penetrating keratoplasty (corneal transplant) or lamellar22
keratoplasty.23
(c) The administration of general anesthesia.24
(d) Laser or nonlaser injection into the vitreous chamber of the eye to25
treat any macular or retinal disease.26
(e) The following nonlaser surgical procedures:27
(i) Surgery related to removal of the eye from a living human being.28
(ii) Surgery requiring full thickness incision or excision of the cornea or29 SB NO. 509
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sclera other than paracentesis in an emergency situation requiring immediate1
reduction of the pressure inside the eye.2
(iii) Surgery requiring incision of the iris and ciliary body, including iris3
diathermy or cryotherapy.4
(iv) Surgery requiring incision of the vitreous.5
(v) Surgery requiring incision of the retina.6
(vi) Surgical extraction of any part of the crystalline lens.7
(vii) Surgical intraocular implants.8
(viii) Incisional or excisional surgery of the extraocular muscles.9
(ix) Surgery of the eyelid for suspect eyelid malignancies or for10
incisional cosmetic or mechanical repair of blepharochalasis, ptosis, and11
tarsorrhaphy.12
(x) Surgery of the bony orbit, including orbital implants.13
(xi) Incisional or excisional surgery of the lacrimal system other than14
lacrimal probing or related procedures.15
(xii) Surgery requiring full thickness conjunctivoplasty with graft or16
flap.17
(xiii) Any surgical procedure that does not provide for the correction18
and relief of ocular abnormalities.19
(xiv) Injection or incision into the eyeball.20
(xv) Retrobulbar injection.21
D. In a public health emergency, the state health officer may authorize22
therapeutically licensed optometrists to administer inoculations for systemic23
health reasons.24
* * *25
§1048. Powers of the board26
The board shall be responsible for the control and regulation of the practice27
of optometry and may:28
* * *29 SB NO. 509
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(15) Require that any therapeutically licensed optometrist authorized1
to practice pursuant to this Chapter shall meet the educational and competence2
criteria established by the board in order to perform expanded therapeutic3
procedures. Evidence of proof of continuing competency shall be determined4
by the board.5
(16) Nothing in this Chapter shall be construed as allowing any agency,6
board, or other entity of this state other than the Louisiana State Board of7
Optometry Examiners to determine what constitutes the practice of optometry.8
(17) The board shall have the sole authority to determine what9
constitutes the practice of optometry and sole jurisdiction to exercise any other10
powers and duties as provided in this Chapter. The board may issue advisory11
opinions and declaratory rulings related to this Chapter and the administrative12
regulations promulgated pursuant to this Chapter.13
§1049. Qualifications and requirements of applicants14
All persons desiring to become licensed to practice optometry shall:15
* * *16
(8) Meet the credentialing requirements of the board to perform17
authorized ophthalmic surgery procedures. 18
Section 2. R.S. 37:1041(C)(2)(b) and (d) and 1061(A)(29) are hereby repealed in19
their entirety.20
Section 3. This Act shall become effective upon signature by the governor or, if not21
signed by the governor, upon expiration of the time for bills to become law without signature22
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If23
vetoed by the governor and subsequently approved by the legislature, this Act shall become24
effective on the day following such approval.25 SB NO. 509
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words in boldface type and underscored are additions.
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Christopher D. Adams.
DIGEST
Nevers (SB 509)
Present law 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 amends 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.
Present law provides "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 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 defines "licensed optometrist" as meaning a person licensed and holding a
certificate issued under the provisions of present law.
Proposed law amends the definition of "licensed optometrist" to mean a person who is an
optometric physician licensed and holding a certificate issued under the provisions of present
law.
Present law 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 provides 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 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. SB NO. 509
SLS 14RS-517 ORIGINAL
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
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.
Proposed law further provides 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, subnormal vision therapy,
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 provides 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) and any form of retroactive surgery.
(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 any part 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.
(n)Injection or incision into the eyeball.
(o)Retro-babar injection. SB NO. 509
SLS 14RS-517 ORIGINAL
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Proposed law provides in a public health emergency, the state health officer may authorize
therapeutically licensed optometrists to administer inoculations for systemic health reasons.
Present law establishes the responsibilities and powers of the board relative to the regulation
of the practice of optometry.
Proposed law adds the following responsibilities:
(1)Require that 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 shall have the sole authority to determine what constitutes the practice of
optometry and sole jurisdiction to exercise any other powers and duties as provided
in present law. The board may issue advisory opinions and declaratory rulings
related to present law and the administrative regulations promulgated pursuant to
present law.
Present law provides 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 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.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Amends R.S. 37:1041(C)(2)(a), (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))