86R6270 KKR-F
By: Hinojosa S.B. No. 1223
A BILL TO BE ENTITLED
AN ACT
relating to the practice of therapeutic optometry; requiring an
occupational certificate to perform certain surgical procedures.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 351.002(7), Occupations Code, is amended
to read as follows:
(7) "Practice of therapeutic optometry" means using
objective or subjective means, [not] including surgery, except as
prohibited by Section 351.4521 [or laser surgery], to:
(A) determine or measure the powers of vision of
the human eye as provided by Section 351.355;
(B) examine or diagnose visual defects, abnormal
conditions, or diseases of the human eye or adnexa;
(C) prescribe or fit lenses or prisms to correct
or remedy a defect or abnormal condition of vision as provided by
Section 351.356;
(D) administer or prescribe a drug or physical
treatment in the manner authorized by this chapter; or
(E) treat the visual system, including the eye or
adnexa as authorized by this chapter.
SECTION 2. The heading to Section 351.151, Occupations
Code, is amended to read as follows:
Sec. 351.151. RULES; INTERPRETATION OF CHAPTER AND RULES.
SECTION 3. Section 351.151, Occupations Code, is amended by
adding Subsection (c) to read as follows:
(c) The board may provide an interpretation of a provision
of this chapter or a rule adopted under this chapter, including by
issuing an advisory opinion or declaratory ruling.
SECTION 4. Subchapter D, Chapter 351, Occupations Code, is
amended by adding Section 351.170 to read as follows:
Sec. 351.170. SOLE AUTHORITY OVER PRACTICE OF OPTOMETRY.
The board has sole authority to regulate optometrists and
therapeutic optometrists and to determine the scope of practice of
an optometrist or therapeutic optometrist.
SECTION 5. Section 351.358, Occupations Code, is amended by
amending Subsections (b) and (c) and adding Subsection (f) to read
as follows:
(b) A therapeutic optometrist may[:
[(1)] administer, perform, or prescribe ophthalmic
devices, procedures, and appropriate medications administered by
any [topical or oral] means[, in accordance with this section and
Section 351.3581,] to diagnose or treat visual defects, abnormal
conditions, or diseases of the human vision system, including the
eye and adnexa[; or
[(2) administer medication by parenteral means for a
purpose and in a manner prescribed by Subsection (e)].
(c) A therapeutic optometrist may prescribe not more than
[oral medications only in the following classifications of oral
pharmaceuticals]:
(1) [one 10-day supply of oral antibiotics;
[(2) one 72-hour supply of oral antihistamines;
[(3) one seven-day supply of oral nonsteroidal
anti-inflammatories;
[(4)] one three-day supply of any medication
classified as a controlled substance under Schedule [analgesic
identified in Schedules] III, IV, or [and] V of 21 U.S.C. Section
812; and
(2) one three-day supply of hydrocodone or a
hydrocodone combination medication classified as a controlled
substance under Schedule II of 21 U.S.C. Section 812 [(5) any
other oral pharmaceutical recommended by the Optometric Health Care
Advisory Committee and approved by the board and the Texas State
Board of Medical Examiners].
(f) A therapeutic optometrist may administer, perform,
prescribe, or order diagnostic studies, analyses, tests, imaging
studies, or laboratory tests necessary to diagnose or treat visual
defects, abnormal conditions, or diseases of the human vision
system, including the eye and adnexa.
SECTION 6. The heading to Section 351.3581, Occupations
Code, is amended to read as follows:
Sec. 351.3581. [DIAGNOSIS AND] TREATMENT OF GLAUCOMA.
SECTION 7. Section 351.3581(a), Occupations Code, is
amended to read as follows:
(a) A therapeutic optometrist may not administer or
prescribe an oral or parenteral medication or treat glaucoma unless
the therapeutic optometrist holds a certificate issued by the
board. A therapeutic optometrist certified under this section
[subsection] shall be known as an optometric glaucoma specialist.
To obtain a certificate, a therapeutic optometrist must [as
required under Section 351.165(c)]:
(1) complete an instructional clinical review course;
and
(2) pass an examination approved by the board.
SECTION 8. Subchapter H, Chapter 351, Occupations Code, is
amended by adding Section 351.3582 to read as follows:
Sec. 351.3582. CERTAIN SURGICAL PROCEDURES: CERTIFICATE
REQUIRED. A therapeutic optometrist may not perform a surgical
procedure described by Section 351.4521(b) unless the therapeutic
optometrist holds a certificate issued by the board. To obtain a
certificate, a therapeutic optometrist must:
(1) complete an instructional clinical review course;
and
(2) pass an examination approved by the board.
SECTION 9. Section 351.4521, Occupations Code, is amended
to read as follows:
Sec. 351.4521. PERFORMANCE OF CERTAIN SURGICAL PROCEDURES
BY THERAPEUTIC OPTOMETRISTS [SURGERY] PROHIBITED. (a) A
therapeutic optometrist may not perform the following surgical
procedures:
(1) retinal laser procedures;
(2) laser-assisted in situ keratomileusis (LASIK),
photorefractive keratectomy (PRK), or laser epithelial
keratomileusis (LASEK);
(3) penetrating keratoplasty, corneal transplant, or
lamellar keratoplasty;
(4) a surgical procedure that requires the
administration of general anesthesia;
(5) intraocular injection;
(6) a surgical procedure relating to the removal of
the eye from a living person;
(7) surgical intraocular implants;
(8) surgery of the eyelid for a suspected eyelid
malignancy;
(9) tarsorrhaphy;
(10) surgery of the bony orbit, including orbital
implants; and
(11) retrobulbar injection or injection into the
extraocular orbital space.
(b) A therapeutic optometrist may not perform the following
surgical procedures unless the therapeutic optometrist holds a
certificate under Section 351.3582 and the procedure is performed
using laser or any form of ionizing or non-ionizing radiation:
(1) a surgical procedure 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 of the eye;
(2) a surgical procedure requiring incision or
excision of the iris and ciliary body;
(3) a surgical procedure requiring incision or
excision of the vitreous;
(4) a surgical procedure requiring incision or
excision of the retina;
(5) a surgical procedure requiring incision or
excision of the crystalline lens;
(6) a surgical procedure requiring incision or
excision of the extraocular muscles;
(7) the incisional or excisional repair of
blepharochalasis, dermatochalasis, or ptosis;
(8) a surgical procedure requiring incision or
excision of the lacrimal system other than lacrimal probing and
related procedures;
(9) a surgical procedure requiring conjunctivoplasty
with graft or flap; and
(10) a surgical procedure requiring incision or
excision of pterygium [surgery or laser surgery].
(c) This section does not:
(1) prevent a therapeutic optometrist from providing
preoperative or postoperative care relating to a surgical procedure
listed in Subsection (a) or (b); or
(2) limit the use of a diagnostic or therapeutic
instrument necessary to perform surgical treatments or procedures
to the eye or adnexa except for those treatments or procedures
specifically prohibited by this section.
SECTION 10. Not later than December 1, 2019, the Texas
Optometry Board shall adopt rules necessary to implement the
changes in law made by this Act to Chapter 351, Occupations Code.
SECTION 11. The following provisions of the Occupations
Code are repealed:
(1) Section 351.160;
(2) Section 351.358(d); and
(3) Sections 351.3581(b), (c), (d), (e), (f), (g),
(h), (i), and (j).
SECTION 12. This Act takes effect September 1, 2019.