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. 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.
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))