Texas 2021 - 87th Regular

Texas House Bill HB2340 Compare Versions

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11 87R5920 KKR-F
22 By: Klick H.B. No. 2340
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55 A BILL TO BE ENTITLED
66 AN ACT
77 relating to the practice of therapeutic optometry; requiring an
88 occupational certificate to perform certain surgical procedures.
99 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1010 SECTION 1. Section 351.002(7), Occupations Code, is amended
1111 to read as follows:
1212 (7) "Practice of therapeutic optometry" means using
1313 objective or subjective means, [not] including surgery, except as
1414 prohibited by Section 351.4521 [or laser surgery], to:
1515 (A) determine or measure the powers of vision of
1616 the human eye as provided by Section 351.355;
1717 (B) examine or diagnose visual defects, abnormal
1818 conditions, or diseases of the human eye or adnexa;
1919 (C) prescribe or fit lenses or prisms to correct
2020 or remedy a defect or abnormal condition of vision as provided by
2121 Section 351.356;
2222 (D) administer or prescribe a drug or physical
2323 treatment in the manner authorized by this chapter; or
2424 (E) treat the visual system, including the eye or
2525 adnexa as authorized by this chapter.
2626 SECTION 2. The heading to Section 351.151, Occupations
2727 Code, is amended to read as follows:
2828 Sec. 351.151. RULES; INTERPRETATION OF CHAPTER AND RULES.
2929 SECTION 3. Section 351.151, Occupations Code, is amended by
3030 adding Subsection (c) to read as follows:
3131 (c) The board may provide an interpretation of a provision
3232 of this chapter or a rule adopted under this chapter, including by
3333 issuing an advisory opinion or declaratory ruling.
3434 SECTION 4. Subchapter D, Chapter 351, Occupations Code, is
3535 amended by adding Section 351.170 to read as follows:
3636 Sec. 351.170. SOLE AUTHORITY OVER PRACTICE OF OPTOMETRY.
3737 The board has sole authority to regulate optometrists and
3838 therapeutic optometrists and to determine the scope of practice of
3939 an optometrist or therapeutic optometrist.
4040 SECTION 5. Section 351.358, Occupations Code, is amended by
4141 amending Subsections (b) and (c) and adding Subsection (f) to read
4242 as follows:
4343 (b) A therapeutic optometrist may[:
4444 [(1)] administer, perform, or prescribe ophthalmic
4545 devices, procedures, and appropriate medications administered by
4646 any [topical or oral] means[, in accordance with this section and
4747 Section 351.3581,] to diagnose or treat visual defects, abnormal
4848 conditions, or diseases of the human vision system, including the
4949 eye and adnexa[; or
5050 [(2) administer medication by parenteral means for a
5151 purpose and in a manner prescribed by Subsection (e)].
5252 (c) A therapeutic optometrist may prescribe not more than
5353 [oral medications only in the following classifications of oral
5454 pharmaceuticals]:
5555 (1) [one 10-day supply of oral antibiotics;
5656 [(2) one 72-hour supply of oral antihistamines;
5757 [(3) one seven-day supply of oral nonsteroidal
5858 anti-inflammatories;
5959 [(4)] one three-day supply of any medication
6060 classified as a controlled substance under Schedule [analgesic
6161 identified in Schedules] III, IV, or [and] V of 21 U.S.C. Section
6262 812; and
6363 (2) one three-day supply of hydrocodone or a
6464 hydrocodone combination medication classified as a controlled
6565 substance under Schedule II of 21 U.S.C. Section 812 [(5) any
6666 other oral pharmaceutical recommended by the Optometric Health Care
6767 Advisory Committee and approved by the board and the Texas State
6868 Board of Medical Examiners].
6969 (f) A therapeutic optometrist may administer, perform,
7070 prescribe, or order diagnostic studies, analyses, tests, imaging
7171 studies, or laboratory tests necessary to diagnose or treat visual
7272 defects, abnormal conditions, or diseases of the human vision
7373 system, including the eye and adnexa.
7474 SECTION 6. The heading to Section 351.3581, Occupations
7575 Code, is amended to read as follows:
7676 Sec. 351.3581. [DIAGNOSIS AND] TREATMENT OF GLAUCOMA.
7777 SECTION 7. Section 351.3581(a), Occupations Code, is
7878 amended to read as follows:
7979 (a) A therapeutic optometrist may not administer or
8080 prescribe an oral or parenteral medication or treat glaucoma unless
8181 the therapeutic optometrist holds a certificate issued by the
8282 board. A therapeutic optometrist certified under this section
8383 [subsection] shall be known as an optometric glaucoma specialist.
8484 To obtain a certificate, a therapeutic optometrist must [as
8585 required under Section 351.165(c)]:
8686 (1) complete an instructional clinical review course;
8787 and
8888 (2) pass an examination approved by the board.
8989 SECTION 8. Subchapter H, Chapter 351, Occupations Code, is
9090 amended by adding Section 351.3582 to read as follows:
9191 Sec. 351.3582. CERTAIN SURGICAL PROCEDURES: CERTIFICATE
9292 REQUIRED. A therapeutic optometrist may not perform a surgical
9393 procedure described by Section 351.4521(b) unless the therapeutic
9494 optometrist holds a certificate issued by the board. To obtain a
9595 certificate, a therapeutic optometrist must:
9696 (1) complete an instructional clinical review course;
9797 and
9898 (2) pass an examination approved by the board.
9999 SECTION 9. Section 351.4521, Occupations Code, is amended
100100 to read as follows:
101101 Sec. 351.4521. PERFORMANCE OF CERTAIN SURGICAL PROCEDURES
102102 BY THERAPEUTIC OPTOMETRISTS [SURGERY] PROHIBITED. (a) A
103103 therapeutic optometrist may not perform the following surgical
104104 procedures:
105105 (1) retinal laser procedures;
106106 (2) laser-assisted in situ keratomileusis (LASIK),
107107 photorefractive keratectomy (PRK), or laser epithelial
108108 keratomileusis (LASEK);
109109 (3) penetrating keratoplasty, corneal transplant, or
110110 lamellar keratoplasty;
111111 (4) a surgical procedure that requires the
112112 administration of general anesthesia;
113113 (5) intraocular injection;
114114 (6) a surgical procedure relating to the removal of
115115 the eye from a living person;
116116 (7) surgical intraocular implants;
117117 (8) surgery of the eyelid for a suspected eyelid
118118 malignancy;
119119 (9) tarsorrhaphy;
120120 (10) surgery of the bony orbit, including orbital
121121 implants; and
122122 (11) retrobulbar injection or injection into the
123123 extraocular orbital space.
124124 (b) A therapeutic optometrist may not perform the following
125125 surgical procedures unless the therapeutic optometrist holds a
126126 certificate under Section 351.3582 and the procedure is performed
127127 using laser or any form of ionizing or non-ionizing radiation:
128128 (1) a surgical procedure requiring full-thickness
129129 incision or excision of the cornea or sclera other than
130130 paracentesis in an emergency situation requiring immediate
131131 reduction of the pressure inside of the eye;
132132 (2) a surgical procedure requiring incision or
133133 excision of the iris and ciliary body;
134134 (3) a surgical procedure requiring incision or
135135 excision of the vitreous;
136136 (4) a surgical procedure requiring incision or
137137 excision of the retina;
138138 (5) a surgical procedure requiring incision or
139139 excision of the crystalline lens;
140140 (6) a surgical procedure requiring incision or
141141 excision of the extraocular muscles;
142142 (7) the incisional or excisional repair of
143143 blepharochalasis, dermatochalasis, or ptosis;
144144 (8) a surgical procedure requiring incision or
145145 excision of the lacrimal system other than lacrimal probing and
146146 related procedures;
147147 (9) a surgical procedure requiring conjunctivoplasty
148148 with graft or flap; and
149149 (10) a surgical procedure requiring incision or
150150 excision of pterygium [surgery or laser surgery].
151151 (c) This section does not:
152152 (1) prevent a therapeutic optometrist from providing
153153 preoperative or postoperative care relating to a surgical procedure
154154 listed in Subsection (a) or (b); or
155155 (2) limit the use of a diagnostic or therapeutic
156156 instrument necessary to perform surgical treatments or procedures
157157 to the eye or adnexa except for those treatments or procedures
158158 specifically prohibited by this section.
159159 SECTION 10. Not later than December 1, 2021, the Texas
160160 Optometry Board shall adopt rules necessary to implement the
161161 changes in law made by this Act to Chapter 351, Occupations Code.
162162 SECTION 11. The following provisions of the Occupations
163163 Code are repealed:
164164 (1) Section 351.160;
165165 (2) Section 351.358(d); and
166166 (3) Sections 351.3581(b), (c), (d), (e), (f), (g),
167167 (h), (i), and (j).
168168 SECTION 12. This Act takes effect September 1, 2021.