EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
FIRST REGULAR SESSION
SENATE BILL NO. 219
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR BLACK.
1393S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal section 336.010, RSMo, and to enact in lieu thereof one new section relating to the
practice of optometry.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 336.010, RSMo, is repealed and one new 1
section enacted in lieu thereof, to be known as section 336.010, 2
to read as follows:3
336.010. 1. The "practice of optometry" is the 1
examination, diagnosis, [treatment, and preventative care ] 2
prevention, and treatment, surgical or nonsurgical, of the 3
eye, adnexa, and vision. The practice includes, but is not 4
limited to: 5
(1) The examination of the eye, adnex a, and vision to 6
determine the accommodative and refractive states, visual 7
perception, conditions, and diseases; 8
(2) The diagnosis and treatment of conditions or 9
diseases of the eye, adnexa, and vision; 10
(3) The performance of diagnostic proc edures and 11
ordering of laboratory and imaging tests for the diagnosis 12
of vision and conditions and diseases of the eye and adnexa; 13
(4) The prescription and administration of 14
pharmaceutical agents [, excluding injectable agents, ] for 15
the purpose of examination, diagnosis, and treatment of 16
vision and conditions or diseases of the eye and adnexa; 17 SB 219 2
(5) The removal of superficial foreign bodies from the 18
eye or adnexa; 19
(6) Notwithstanding the provisions of any other law to 20
the contrary, including section 334.010, the correction and 21
relief of ocular abnormalities by surgical procedures not 22
excluded under subsection 2 of this section; 23
(7) The employment of objective or subjective 24
mechanical means to determine the accommodative or 25
refractive states of the human eye; 26
[(7)] (8) The prescription or adaptation of lenses, 27
prisms, devices, or ocular exercises to correct defects or 28
abnormal conditions of the human eye or vision or to adjust 29
the human eye to special conditions; 30
[(8)] (9) The prescription and fitting of ophthalmic 31
or contact lenses and devices; 32
[(9)] (10) The prescription and administration of 33
vision therapy; and 34
[(10)] (11) The prescription and administration of low 35
vision care. 36
2. The board shall continue to review surgical 37
procedures not listed in this subsection but which shall be 38
excluded from the scope of the practice of optometry. The 39
following procedures are not within the scope of optometry 40
and an optometrist [may] shall not perform [surgery, 41
including the use of lasers for treatment of any disease or 42
condition or for the correction of refractive error ] such 43
procedures, except for the preoperative and postoperative 44
care of these procedures: 45
(1) Retina laser procedures, la ser-assisted in situ 46
keratomileusis (LASIK), and photorefractive keratectomy 47
(PRK); 48 SB 219 3
(2) Nonlaser surgery related to removal of the eye 49
from a living human being; 50
(3) Nonlaser surgery requiring full thickness incision 51
or excision of the corn ea or sclera other than paracentesis 52
in an emergency situation requiring immediate reduction of 53
the pressure inside the eye; 54
(4) Penetrating keratoplasty (corneal transplant) or 55
lamellar keratoplasty; 56
(5) Nonlaser surgery requiring incision of the iris 57
and ciliary body, including iris diathermy or cryotherapy; 58
(6) Nonlaser surgery requiring incision of the 59
vitreous; 60
(7) Nonlaser surgery requiring incision of the retina; 61
(8) Nonlaser surgical extraction of the crystalline 62
lens; 63
(9) Nonlaser surgical intraocular implants; 64
(10) Incisional or excisional nonlaser surgery of the 65
extraocular muscles; 66
(11) Nonlaser surgery of the eyelid for eyelid 67
malignancies or for incisional cosmetic or mechanical repair 68
of blepharochalasis, ptosis, and tarsorrhaphy; 69
(12) Nonlaser surgery of the bony orbit, including 70
orbital implants; 71
(13) Incisional or excisional nonlaser surgery of the 72
lacrimal system other than lacrimal probing or related 73
procedures; 74
(14) Nonlaser surgery requiring full thickness 75
conjunctivoplasty with graft or flap; 76
(15) Any nonlaser surgical procedure that does not 77
provide for the correction and relief of ocular 78
abnormalities; 79 SB 219 4
(16) Laser or nonlaser injection into the posterior 80
chamber of the eye to treat any macular or retinal disease; 81
and 82
(17) The administration of general anesthesia . 83
3. As used in this chapter, except as the context may 84
otherwise require, the following terms mean: 85
(1) "Eye", the human eye; 86
(2) "Adnexa", all structures adjacent to the eye and 87
the conjunctiva, lids, lashes, and lacrimal system; 88
(3) "Board", the Missouri state board of optometry; 89
(4) "Diagnostic pharmaceutical agents", topically 90
applied pharmaceuticals used for the purpose of conducting 91
an examination of the eye, adnexa, and vision; 92
(5) "Low vision care", the examination, treatment, and 93
management of patients with visual impairments not treatable 94
by conventional eyewear or contact len ses and may include a 95
vision rehabilitation program to enhance remaining vision 96
skills; 97
(6) "Pharmaceutical agents", any diagnostic and 98
therapeutic drug or combination of drugs that assist the 99
diagnosis, prevention, treatment, or mitigation of a bnormal 100
conditions or symptoms of the human eye, adnexa, and vision; 101
(7) "Therapeutic pharmaceutical agents", those 102
pharmaceuticals[, excluding injectable agents, ] used for the 103
treatment of conditions or diseases of the eye, adnexa, and 104
vision; 105
(8) "Vision therapy", a treatment regiment to improve 106
a patient's diagnosed visual dysfunctions, prevent the 107
development of visual problems, or enhance visual 108
performance to meet the defined needs of the patient. 109