Part 14.
TEXAS OPTOMETRY BOARD
Chapter 273.
GENERAL RULES
22 TAC §273.4
The Texas Optometry Board proposes amendments to §273.4
in order to implement the amendments to article 4552-1.03 made by H.B. 1051,
76th Legislature, Regular Session, by setting an application fee for the optometric
glaucoma specialist license.
Lois Ewald, executive director of the Texas Optometry Board, has determined
that for the first five-year period the amendments are in effect, there will
be no fiscal implications for local governments as a result of enforcing or
administering the amendments. Ms. Ewald has also determined that for the first
five-year period the amendments are in effect, the fiscal implications for
state government as a result of enforcing or administering the rule is a probable
additional revenue of $29,200 the first year, $19,250 the second year, and
$12,500 for each year thereafter which is offset by probable expenses of $27,319
for the first year, $3,712 for the second year, and $3,150 for each year thereafter
of the first five year period. The Board forecast and based the fee amount
on the projection that one-third of the Texas resident therapeutic optometrists,
or 584 individuals, will apply for licensure the first year, two-thirds of
that number, or 385, the second year, and 150 current license holders and
100 new graduates each year thereafter.
Lois Ewald also has determined that for each of the first five years the
amendments are in effect, the public benefit anticipated as a result of enforcing
the amendment is that the costs of licensing optometric glaucoma specialist
are borne by the license applicants. It has also been determined that therapeutic
optometrists who choose to apply for the voluntary additional licensure will
be required to pay the $50 application fee. Those therapeutic optometrists
obtaining the optometric glaucoma specialist license will then be able to
treat an additional class of patients. The amendment does not impose any duties
on small and micro businesses. Should a therapeutic optometrist voluntarily
decide to obtain this additional licensure, the application fee is the same
for each licensee. Therefore no adverse economic effect on small or micro
businesses is forecast pertaining to the voluntary decision to obtain a new
license. The Board solicits comments regarding any possible disparate economic
impact on small or micro businesses.
Comments on the proposal may be submitted to Lois Ewald, Executive Director,
Texas Optometry Board, 333 Guadalupe Street, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is 30 days after publication in the
The amendment is proposed under the Texas Optometry Act, Texas
Occupations Code, §351.151, §351.152, and Texas Revised Civil Statutes,
article 4552-1.03. The amendment affects §351.152.
The Texas Optometry Board interprets §351.151 as authorizing the adoption
of procedural and substantive rules for the regulation of the optometric profession.
The Board interprets §351.152 as authorizing the adoption of fees. The
Board interprets article 4552-1.03 as authorizing the licensure of optometric
glaucoma specialists.
§273.4.Fees (Not Refundable).
(a)
Examination Fee $150.00
(b)
Initial Therapeutic License
$
50.00
(c)
Provisional License
$
75.00
(d)
Limited Faculty License
$
50.00
(e)
Duplicate License (lost, destroyed, or name change)
$
25.00
(f)
Duplicate/Amended Renewal Certificate (lost, destroyed,
inactive, active)
$
25.00
(g)
License Renewal $150.00
(h)
Late fees (for all renewals, one to 90 days)
$
75.00
(i)
Late fees (for all renewals, 90 days to 1 year)
$
150.00
(j)
Late fees (for all renewals with delayed continuing education)
$150.00
(k)
Therapeutic Certification Application
$
80.00
(l)
Duplicate Therapeutic
or Optometric Glaucoma Specialist
Certificate (lost, destroyed)
$
25.00
(m)
License Without Examination Fee $300.00
(n)
Optometric Glaucoma Specialist License
Application $50.00
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on April 17, 2000.
TRD-200002717
Lois Ewald
Executive Director
Texas Optometry Board
Proposed date of adoption: July 14, 2000
For further information, please call: (512) 305-8502
22 TAC §280.5
The Texas Optometry Board proposes amendments to §280.5
in order to implement the amendments to article 4552-1.03 made by H.B. 1051,
76th Legislature, Regular Session, including the addition of antivirals to
list of drugs that therapeutic optometrists may administer and prescribe.
The rule amendments add cross references to new rules and change citations
to laws now codified in the Occupations Code.
Lois Ewald, executive director of the Texas Optometry Board, has determined
that for the first five-year period the amendments are in effect, there will
be no fiscal implications for state and local governments as a result of enforcing
or administering the amendments.
Lois Ewald also has determined that for each of the first five years the
amendments are in effect, the public benefit anticipated as a result of enforcing
the amendments is that therapeutic optometrists will know which drugs they
are authorized to administer and prescribe. It has also been determined that
the amendments do not impose any costs for optometrists to comply with the
rule. The amendments do not impose any new duties on small and micro businesses.
Therefore no adverse economic effect on small or micro businesses is forecast.
The Board solicits comments regarding any possible disparate economic impact
on small or micro businesses.
Comments on the proposal may be submitted to Lois Ewald, Executive Director,
Texas Optometry Board, 333 Guadalupe Street, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is 30 days after publication in the
The amendment is proposed under the Texas Optometry Act, Texas
Occupations Code, §351.151 and Texas Revised Civil Statutes, article
4552-1.03. The amendment affects article 4552-1.03.
The Texas Optometry Board interprets §351.151 as authorizing the adoption
of procedural and substantive rules for the regulation of the optometric profession.
The Board interprets article 4552-1.03 as defining the drugs available for
administering and prescribing by therapeutic optometrists.
§280.5.Prescription and Diagnostic Drugs for Therapeutic Optometry
(a)
A [
(b)
As specified in the Texas Pharmacy Act (
§562.008
and §563.002, Texas Occupations Code
[
(c)
All prescriptions shall contain the following information:
(1)
the date of issuance;
(2)
the name and address of the patient for whom the drug
is prescribed;
(3)
the name, strength, and quantity of the drug, medicine,
or device prescribed;
(4)
the directions for use of the drug, medicine, or device
prescribed;
(5)
the name and address of the therapeutic optometrist;
(6)
the written signature of the prescribing therapeutic
optometrist; and
(7)
the license number of the prescribing therapeutic
optometrist including the [
(d) - (f)
(No change.)
(g)
A therapeutic optometrist may administer and prescribe
all:
(1)
ophthalmic devices;
(2)
over-the-counter oral medications; and
(3)
appropriate topical pharmaceutical agents used for
diagnosing and treating visual defects, abnormal conditions, and diseases
of the human eye and adnexa, which are included in the following classifications
or are combinations of agents in the classifications. No drug falling within
one of the following categories may be used for the treatment of glaucoma
in a manner that was not permitted by law on August 31, 1991:
(A)
anti-allergy:
(i)
antihistamine;
(ii)
membrane stabilizer;
(B)
anti-fungal:
(i)
imidazoles;
(ii)
polyenes;
(C)
anti-infective:
(i)
aminoglycoside;
(ii)
anti-cell membrane;
(iii)
anti-cell wall synthesis;
(iv)
anti-DNA synthesis;
(v)
anti-protein synthesis (excluding chloramphenicol);
(vi)
anti-ACHase;
(vii)
cephalosporin;
(viii)
agents affecting intermediary metabolism;
(D)
anti-inflammatory:
(i)
nonsteroidal anti-inflammatory drug (NSAID);
(ii)
steroid;
(E)
antiseptic;
(F)
chelating agent;
(G)
chemical cautery;
(H)
cycloplegic: parasympatholytic;
(I)
hyperosmotic;
(J)
miotic:
(i)
anti-ACHase;
(ii)
parasympathomimetic;
(K)
mucolytic;
(L)
mydriatic: sympathomimetic (Alpha 1 agonists only);
(M)
vasoconstrictor: sympathomimetic (Alpha 1 agonists only)
(N)
antivirals.
(h)
The authority of an optometric glaucoma specialist
to prescribe antiglaucoma drugs is defined in §280.10.
The following
are those drugs which are classified as antiglaucoma drugs and may not be
used
by a therapeutic optometrist
in a manner that was not permitted
by law on August 31, 1991:
(1)
Pilocarpine 1%-10%
(2)
Carbachol 0.75%-3%
(3)
Carteolol
(4)
Epinephrine 0.25%-2%
(5)
Dipivefrin 0.1%
(6)
Betaxolol 0.5%
(7)
Levobunolol 0.5%
(8)
Metipranolol 0.3%
(9)
Timolol 0.25%-0.5%
(10)
Physostigmine 0.25%-0.5%
(11)
Demecarium 0.125%-0.25%
(12)
Echothiophate 0.03%-0.25%
(13)
Isoflurophate 0.25%
(i)
(No change.)
(j)
A therapeutic optometrist may possess and administer cocaine
eye drops for diagnostic purpose. The cocaine eye drops must be no greater
than 10 percent solution in prepackaged liquid form.
(1)
A therapeutic optometrist must observe all requirements
of the Texas Controlled Substances Act, the Health and Safety Code, Chapter
481, and all requirements of the Texas Department of Public Safety (DPS) Drug
Rules, in making application and maintaining renewal of a United States Drug
Enforcement Administration (DEA) registration number for possession of the
cocaine eye drops, a Schedule II controlled substance.
(2)
A therapeutic optometrist must obtain a registration
number from the DPS for the principal office of practice. Application may
be made for a separate registration for the practice of optometry at a satellite
office but all requirements of this rule shall apply in all locations.
(3)
The therapeutic optometrist must use the required
DEA form for the purchase of the cocaine eye drops and shall maintain a complete
and accurate record of purchases (to include samples received from pharmaceutical
manufacturer representatives) and administration of controlled substances.
The maximum amount to be purchased and maintained in an office of practice
shall be no more than two vials, one opened and one in inventory.
(4)
The recordkeeping listed in this section shall be
subject to inspection at all times by the Texas Department of Public Safety,
the U.S. Drug Enforcement Administration, and the Texas Optometry Board and
any officer or employee of the governmental agencies shall have the right
to inspect and copy records, reports, and other documents, and inspect security
controls, inventory and premises where such cocaine eye drops are possessed
or administered.
(5)
Minimum security controls shall be established to
include but not limited to:
(A)
establishing adequate security to prevent unauthorized
access and diversion of the controlled substance,
(B)
during the course of business activities, not allowing
any individual access to the storage area for controlled substances except
those authorized by the therapeutic optometrist,
(C)
storing the controlled substance in a securely locked,
substantially constructed cabinet or security cabinet which shall meet the
requirements under the DPS Drug Rules,
(D)
not employ in any manner an individual that would have
access to controlled substances who has had a federal or state application
for controlled substances denied or revoked, or have been convicted of a felony
offense under any state or federal law relating to controlled substances or
been convicted of any other felony, or have been a licensee of a health regulatory
agency whose license has been revoked, canceled, or suspended.
(6)
Failure of the therapeutic optometrist to maintain
strict security and proper accountability of controlled substance shall be
deemed to be a violation of the Texas Optometry Act, [
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on April 17, 2000.
TRD-200002716
Lois Ewald
Executive Director
Texas Optometry Board
Proposed date of adoption: July 14, 2000
For further information, please call: (512) 305-8502
22 TAC §280.6
The Texas Optometry Board proposes amendments to §280.6
in order to distinguish between licensure and certification and thus prevent
misleading advertising language regarding certification by organizations separate
from the Board. The rule amendments change citations to laws now codified
in the Occupations Code.
Lois Ewald, executive director of the Texas Optometry Board, has determined
that for the first five-year period the amendments are in effect, there will
be no fiscal implications for state and local governments as a result of enforcing
or administering the amendments.
Lois Ewald also has determined that for each of the first five years the
amendments are in effect, the public benefit anticipated as a result of enforcing
the amendments is that potential patients will have a clear understanding
of the license holder's practice authority. It has also been determined that
the amendments may impose a minimal cost for some license holders who may
be required to change advertising statements upon replacing an advertisement
or reprinting, but the actual costs related to compliance with the rule are
predicted to be minimal. This change is not predicted to place a greater burden
on a small or micro business. The Board solicits comments regarding any possible
disparate economic impact on small or micro businesses.
Comments on the proposal may be submitted to Lois Ewald, Executive Director,
Texas Optometry Board, 333 Guadalupe Street, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is 30 days after publication in the
The amendment is proposed under the Texas Optometry Act, Texas
Occupations Code, §351.151, §351.155 and §351.403. The amendment
affects §351.155 and §351.403.
The Texas Optometry Board interprets §351.151 as authorizing the adoption
of procedural and substantive rules for the regulation of the optometric profession.
The Board interprets §351.155 and §351.403 as authorizing rules
to prevent misleading advertising.
§280.6. Advertising by [
All advertising must be in compliance with the Texas Optometry Act,
[
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on April 17, 2000.
TRD-200002715
Lois Ewald
Executive Director
Texas Optometry Board
Proposed date of adoption: July 14, 2000
For further information, please call: (512) 305-8502
22 TAC §280.8
The Texas Optometry Board proposes new §280.8 in order
to implement the licensure of optometric glaucoma specialists as authorized
by the amendments to article 4552-1.03 made by H.B. 1051, 76th Legislature,
Regular Session. The new rule defines the education, examination, and clinical
skills requirements for licensure.
Lois Ewald, executive director of the Texas Optometry Board, has determined
that for the first five-year period the new rule is in effect, there will
be no fiscal implications for state and local governments as a result of enforcing
or administering the rule.
Lois Ewald also has determined that for each of the first five years the
new rule is in effect, the public benefit anticipated as a result of enforcing
the new rule is that the public will be assured that only qualified therapeutic
optometrists meeting all of the specific statutory standards will be licensed
to treat glaucoma. It has also been determined that therapeutic optometrists
who choose to apply for the voluntary additional licensure will be required
to take and pay for an educational course and examination. Those therapeutic
optometrists obtaining the optometric glaucoma specialist license will then
be able to treat an additional class of patients. The new rule does not impose
any duties on small and micro businesses. Should a therapeutic optometrist
voluntarily decide to obtain this additional licensure, the costs associated
with the new license are predicted to be the same for each licensee. Therefore
no adverse economic effect on small or micro businesses is forecast pertaining
to the voluntary decision to obtain a new license. The Board solicits comments
regarding any possible disparate economic impact on small or micro businesses.
Comments on the proposal may be submitted to Lois Ewald, Executive Director,
Texas Optometry Board, 333 Guadalupe Street, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is 30 days after publication in the
The new rule is proposed under the Texas Optometry Act, Texas
Occupations Code, §351.151 and Texas Revised Civil Statutes, articles
4552-1.03 and 1.03A. The new rule affects article 4552-1.03.
The Texas Optometry Board interprets §351.151 as authorizing the adoption
of procedural and substantive rules for the regulation of the optometric profession.
The Board interprets articles 4552-1.03 and 1.03A as defining the requirements
for licensure as an optometric glaucoma specialist.
§280.8.Optometric Glaucoma Specialist: Required Education, Examination and Clinical Skills Evaluation.
(a)
Education Required.
(1)
Successful completion of at least 30 classroom hours of
board approved postgraduate course work in glaucoma diagnosis and treatment
and pharmacology of approved oral and antiglaucoma drugs is required for licensure
as an optometric glaucoma specialist. The applicant must provide documentation
of successful completion of course work.
(2)
To be acceptable, courses of classroom hours must
receive prior approval by the board. Approved courses may be given only by
accredited colleges and schools of optometry or via other educational programs
approved by the board. Successfully completed classroom hours may be used
to satisfy the continuing education requirements for that year.
(b)
Examination. Each applicant for licensure as an optometric
glaucoma specialist shall have passed, with a grade of 75 or above, a Board
approved examination covering the 30 classroom hours defined in this rule.
The examination must have received prior approval by the board. The applicant
must provide documentation of passing the examination. Examinations given
by accredited schools of optometry or medicine covering the subjects described
in the Board's Resolution dated April 14, 2000, are hereby approved.
(c)
Clinical Skills Evaluation. Each applicant for licensure
as an optometric glaucoma specialist shall submit a signed and dated certification
prepared by a licensed ophthalmologist. The certification shall confirm the
demonstration by the applicant in an adequate and appropriate manner, as directly
observed by the ophthalmologist, of the following skills:
(1)
tonometry,
(2)
gonioscopy,
(3)
slit lamp examination,
(4)
optic nerve examination/fundus, and
(5)
interpretation of visual fields.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on April 17, 2000.
TRD-200002714
Lois Ewald
Executive Director
Texas Optometry Board
Proposed date of adoption: July 14, 2000
For further information, please call: (512) 305-8502
22 TAC §280.9
The Texas Optometry Board proposes new §280.9 in order
to implement the licensure of optometric glaucoma specialists as authorized
by the amendments to article 4552-1.03 made by H.B. 1051, 76th Legislature,
Regular Session. The new rule sets out the application process, including
the application fee, and the requirements for displaying the license.
Lois Ewald, executive director of the Texas Optometry Board, has determined
that for the first five-year period the new rule is in effect, there will
be no fiscal implications for local governments as a result of enforcing or
administering the rule. Ms. Ewald has also determined that for the first five-year
period the new rule is in effect, the fiscal implications for state government
as a result of enforcing or administering the rule is a probable expense of
$27,319 for the first year, $3,712 for the second year, and $3,150 for each
year thereafter of the first five year period. This will be offset by probable
additional revenue of $29,200 the first year, $19,250 the second year, and
$12,500 for each year thereafter as a result of the application fee imposed
by the new rule. The Board forecast and based the fee amount on the projection
that one-third of the Texas resident therapeutic optometrists, or 584 individuals,
will apply for licensure the first year, two-thirds of that number, or 385,
the second year, and 150 current license holders and 100 new graduates each
year thereafter.
Lois Ewald also has determined that for each of the first five years the
new rule is in effect, the public benefit anticipated as a result of enforcing
the new rule is that the public will be assured that only qualified therapeutic
optometrists meeting all of the specific statutory standards will be licensed
to treat glaucoma. It has also been determined that therapeutic optometrists
who choose to apply for the voluntary additional licensure will be required
to pay the $50 application fee. Those therapeutic optometrists obtaining the
optometric glaucoma specialist license will then be able to treat an additional
class of patients. The new rule does not impose any duties on small and micro
businesses. Should a therapeutic optometrist voluntarily decide to obtain
this additional licensure, the application fee is the same for each licensee.
Therefore no adverse economic effect on small or micro businesses is forecast
pertaining to the voluntary decision to obtain a new license. The Board solicits
comments regarding any possible disparate economic impact on small or micro
businesses.
Comments on the proposal may be submitted to Lois Ewald, Executive Director,
Texas Optometry Board, 333 Guadalupe Street, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is 30 days after publication in the
The new rule is proposed under the Texas Optometry Act, Texas
Occupations Code, §351.151 and §351.152 and Texas Revised Civil
Statues, article 4552-1.03. The new rule affects article 4552-1.03.
The Texas Optometry Board interprets §351.151 as authorizing the adoption
of procedural and substantive rules for the regulation of the optometric profession.
The Board interprets §351.152 as authorizing the Board to set fees and
article 4552-1.03 as defining the requirements for licensure as an optometric
glaucoma specialist.
§280.9. Application for Licensure as Optometric Glaucoma Specialist.
(a)
A licensed therapeutic optometrist must submit a completed
application on forms provided by the Texas Optometry Board (board) to be eligible
for licensure as an optometric glaucoma specialist. An optometric glaucoma
specialist may:
(1)
administer and prescribe appropriate medications by topical
or oral means for the purpose of diagnosing and treating visual defects, abnormal
conditions and diseases of the human vision system, including the eye and
adnexa, as set forth in §280.10, and
(2)
treat glaucoma, as set forth in §280.10 and §280.11,
including the administration and prescribing of appropriate medications by
topical, oral or parental means.
(b)
A completed application for license as an optometric glaucoma
specialist consists of an application form entirely filled out by the applicant,
signed and notarized, and forwarded to the board along with an application
fee of $50. Proof of the required successfully completed education, examination
and clinical assessment as set forth in §280.8 (relating to Required
Education) must accompany the application form. The Board may license the
applicant as an optometric glaucoma specialist provided the applicant submits
a completed application as defined in this rule, and provided that the applicant
is currently licensed and authorized to practice therapeutic optometry in
this state.
(c)
The license to practice as an optometric glaucoma specialist
must be displayed along with all licenses in a conspicuous place in the principal
office where the optometrist practices.
(d)
Designation of authority as a optometric glaucoma specialist
will appear along with the optometrist's license number in the format of the
license numbers followed by the letter "T" and "G." Such designation must
appear whenever the license number is required under board statutes or board
rules.
(e)
In the event the original certification is lost or destroyed,
the board may issue a duplicate certificate; the person entitled thereto must
make written application to the board for a duplicate, under affidavit setting
forth that such certificate was lost or destroyed, and the circumstances under
which loss or destruction occurred. Should the original subsequently be found,
it must be forwarded immediately to the board and not used by the person to
whom issued originally or by any other person. A fee of $25 must be submitted
to the board along with the affidavit for the duplicate issue.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on April 17, 2000.
TRD-200002713
Lois Ewald
Executive Director
Texas Optometry Board
Proposed date of adoption: July 14, 2000
For further information, please call: (512) 305-8502
22 TAC §280.10
The Texas Optometry Board proposes new §280.10 in order
to implement the practice of optometric glaucoma specialists as authorized
by the amendments to article 4552-1.03 made by H.B. 1051, 76th Legislature,
Regular Session. The new rule defines the classes and permitted uses of drugs
by optometric glaucoma specialists.
Lois Ewald, executive director of the Texas Optometry Board, has determined
that for the first five-year period the new rule is in effect, there will
be no fiscal implications for state and local governments as a result of enforcing
or administering the rule.
Lois Ewald also has determined that for each of the first five years the
new rule is in effect, the public benefit anticipated as a result of enforcing
the new rule is that the public will be assured that optometric glaucoma specialists
will properly prescribe and administer only those drugs authorized by statute.
It has also been determined that the rule does not impose any additional costs
for optometric glaucoma specialists. The new rule does not impose any new
duties on small and micro businesses. Therefore no adverse economic effect
on small or micro businesses is forecast. The Board solicits comments regarding
any possible disparate economic impact on small or micro businesses.
Comments on the proposal may be submitted to Lois Ewald, Executive Director,
Texas Optometry Board, 333 Guadalupe Street, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is 30 days after publication in the
The new rule is proposed under the Texas Optometry Act, Texas
Occupations Code, §351.151 and Texas Revised Civil Statutes, article
4552-1.03. The new rule affects article 4552-1.03.
The Texas Optometry Board interprets §351.151 as authorizing the adoption
of procedural and substantive rules for the regulation of the optometric profession.
The Board interprets article 4552-1.03 as defining the requirements for the
administering and prescribing of drugs by optometric glaucoma specialists.
§280.10. Optometric Glaucoma Specialist: Administration and Prescribing of Oral Medications and Anti-Glaucoma Drugs.
(a)
An optometric glaucoma specialist may administer and prescribe
any drug authorized by the Texas Optometry Act, Article 4552-1.03, as amended
by House Bill 1051, 76th Legislature, Regular Session, in addition to those
drugs that may be administered and prescribed by a therapeutic optometrist.
(b)
The requirements of §280.5 and the statutes cited
in the rule apply to the optometric glaucoma specialist's prescription orders,
the administration of drugs in the optometric office and the labeling of drugs
supplied to patients.
(c)
At least annually, the Texas Optometry Board shall provide
to the Texas State Board of Pharmacy a list of the oral pharmaceutical agents
and anti-glaucoma drugs which may be administered and prescribed by an optometric
glaucoma specialist.
(d)
An optometric glaucoma specialist may administer and prescribe,
in addition to those drugs authorized by §280.5:
(1)
appropriate oral pharmaceutical agents used for diagnosing
and treating visual defects, abnormal conditions, and diseases of the human
vision system, including the eye and adnexa, which are included in the following
classifications or are combinations of agents in the classifications:
(A)
one ten-day supply of oral antibiotics;
(B)
one 72-hour supply of oral antihistamines;
(C)
one seven-day supply of oral nonsteroidal anti-inflammatories;
(D)
one three-day supply of any analgesic identified in Schedules
III, IV, and V of 21 U.S.C. §812; and
(2)
antiglaucoma drugs.
(e)
An optometric glaucoma specialist may administer appropriate
medications to treat a patient who has an anaphylactic reaction in order to
counteract the anaphylaxis. The optometric glaucoma specialist shall immediately
refer the patient to a physician.
(f)
Controlled Substances
(1)
An optometric glaucoma specialist must observe all requirements
of the Texas Controlled Substances Act, the Health and Safety Code, Chapter
481, applicable federal law, and all requirements of the Texas Department
of Public Safety (DPS) Drug Rules, 37 T.A.C. Chapter 13, in making application
and maintaining renewal of a United States Drug Enforcement Administration
(DEA) registration number for possession and prescribing authority of the
Schedule III, IV, and V analgesic controlled substances.
(2)
An optometric glaucoma specialist must obtain a registration
number from the DPS for the principal office of practice. Application may
be made for a separate registration for the possession, administration, and
prescribing of controlled substances at a satellite office but all requirements
of this rule shall apply in all locations.
(3)
The optometric glaucoma specialist shall include
the optometrist's DEA number on all prescriptions for controlled substances.
(4)
The record keeping listed in this section shall be
subject to inspection at all times by the Texas Department of Public Safety,
the U.S. Drug Enforcement Administration, and the Texas Optometry Board and
any officer or employee of the governmental agencies shall have the right
to inspect and copy records, reports, and other documents, and inspect security
controls, inventory and premises where Schedule III, IV, and V analgesic controlled
substances are possessed or administered.
(5)
Minimum security controls shall be established to
include but not limited to:
(A)
establishing adequate security to prevent unauthorized
access and diversion of the controlled substance,
(B)
during the course of business activities, not allowing
any individual access to the storage area for controlled substances except
those authorized by the optometric glaucoma specialist,
(C)
storing the controlled substance in a securely locked,
substantially constructed cabinet or security cabinet which shall meet the
requirements under the DPS Drug Rules, and
(D)
not employ in any manner an individual that would have
access to controlled substances who has had a federal or state application
for controlled substances denied or revoked, or have been convicted of a felony
offense under any state or federal law relating to controlled substances or
been convicted of any other felony, or have been a licensee of a health regulatory
agency whose license has been revoked, canceled, or suspended.
(6)
Failure of the optometric glaucoma specialist
to maintain strict security and proper accountability of controlled substance
shall be deemed to be a violation of the Texas Optometry Act, §351.501
and §351.551.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on April 17, 2000.
TRD-200002712
Lois Ewald
Executive Director
Texas Optometry Board
Proposed date of adoption: July 14, 2000
For further information, please call: (512) 305-8502
22 TAC §280.11
The Texas Optometry Board proposes new §280.11 in order
to implement the practice of optometric glaucoma specialists as authorized
by the amendments to article 4552-1.03 made by H.B. 1051, 76th Legislature,
Regular Session. The new rule defines treatment parameters for optometric
glaucoma specialists.
Lois Ewald, executive director of the Texas Optometry Board, has determined
that for the first five-year period the new rule is in effect, there will
be no fiscal implications for state and local governments as a result of enforcing
or administering the rule.
Lois Ewald also has determined that for each of the first five years the
new rule is in effect, the public benefit anticipated as a result of enforcing
the new rule is that the public will be assured that optometric glaucoma specialists
will practice in accordance with the authority granted by statute. It has
also been determined that the rule does not impose any costs for optometric
glaucoma specialists to comply with the rule. The new rule does not impose
any new duties on small and micro businesses. Therefore no adverse economic
effect on small or micro businesses is forecast. The Board solicits comments
regarding any possible disparate economic impact on small or micro businesses.
Comments on the proposal may be submitted to Lois Ewald, Executive Director,
Texas Optometry Board, 333 Guadalupe Street, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is 30 days after publication in the
The new rule is proposed under the Texas Optometry Act, Texas
Occupations Code, §351.151 and Texas Revised Civil Statutes, article
4552-1.03. The new rule affects article 4552-1.03.
The Texas Optometry Board interprets §351.151 as authorizing the adoption
of procedural and substantive rules for the regulation of the optometric profession.
The Board interprets article 4552-1.03 as defining the authorized treatments
available to optometric glaucoma specialists.
§280.11. Treatment of Glaucoma by an Optometric Glaucoma Specialist.
(a)
An optometric glaucoma specialist may treat glaucoma as
directed by this rule.
(b)
Consultation with an ophthalmologist after an initial
diagnosis of glaucoma.
(1)
Not later than the 30th day after the date of the initial
diagnosis of glaucoma, an optometric glaucoma specialist shall engage in consultation
with an ophthalmologist to develop an individual treatment plan that is approved
by the optometric glaucoma specialist and ophthalmologist.
(2)
The optometric glaucoma specialist shall inform the
patient diagnosed with glaucoma that the optometric glaucoma specialist must
have the diagnosis confirmed and comanaged by an ophthalmologist of the patient's
choosing or, if the patient does not choose an ophthalmologist, an ophthalmologist
practicing in the geographic area in which the optometric glaucoma specialist
practices.
(3)
The parameters of the consultation shall be at the
discretion of the ophthalmologist but must at least include confirmation of
the diagnosis and a plan for comanagement of the patient, including periodic
review of the patient's progress.
(c)
Setting a target pressure on the initial diagnosis of
glaucoma.
(1)
On making an initial diagnosis of glaucoma, an optometric
glaucoma specialist shall set a target pressure that is not more than 80%
of the initial intraocular pressure.
(2)
If the optometric glaucoma specialist determines
that a patient's glaucoma is not responding appropriately to treatment, the
optometric glaucoma specialist shall consult a physician by telephone, fax,
or another method. The patient's glaucoma is considered to not be appropriately
responding to treatment if the patient fails to achieve the target pressure
within an appropriate time. If the physician determines that the patient should
be seen by the physician or an appropriate specialist as a result of the consultation,
the optometric glaucoma specialist shall refer the patient to an ophthalmologist.
(d)
Prescribing a beta blocker.
(1)
Before an optometric glaucoma specialist may prescribe
a beta blocker, the optometric glaucoma specialist must take a complete case
history of the patient and determine whether the patient has had a physical
examination within the 180 days preceding the date of taking the history.
(2)
If the patient has not had a physical examination
or if the patient has a history of congestive heart failure, bradycardia,
heart block, asthma, or chronic obstructive pulmonary disease, the optometric
glaucoma specialist shall refer the patient to a physician for a physical
examination before initiating beta blocker therapy.
(e)
Referral to an ophthalmologist.
(1)
An optometric glaucoma specialist shall refer a patient
to an ophthalmologist if:
(A)
the patient is under 16 years of age and has been diagnosed
as having glaucoma;
(B)
the patient has been diagnosed as having acute closed
angle glaucoma;
(C)
the patient has been diagnosed as having malignant glaucoma
or neovascular glaucoma;
(D)
the optometric glaucoma specialist determines that a patient's
glaucoma is caused by a diabetic complication and, after joint consultation
with the physician treating the diabetes and an ophthalmologist by telephone,
fax, or another method, the physician or ophthalmologist determines that the
patient should be seen by the physician or ophthalmologist; or
(E)
the optometric glaucoma specialist determines that a patient's
glaucoma is not responding appropriately to a treatment as specified in this
rule.
(2)
The optometric glaucoma specialist may initiate
appropriate emergency treatment for a patient diagnosed with acute closed
angle glaucoma, but shall refer the patient to a physician in a timely manner.
(3)
An optometric glaucoma specialist who refers a patient
to a physician or specialist shall inform the patient that the patient may
go to any physician or specialist the patient chooses. This subsection does
not prevent an optometric glaucoma specialist from recommending a physician
or specialist.
(4)
The optometric glaucoma specialist shall maintain
physician reports in the patient's records.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on April 17, 2000.
TRD-200002711
Lois Ewald
Executive Director
Texas Optometry Board
Proposed date of adoption: July 14, 2000
For further information, please call: (512) 305-8502
Chapter 537.
PROFESSIONAL AGREEMENTS AND STANDARD CONTRACTS
Chapter 280.
THERAPEUTIC OPTOMETRY
certified
] therapeutic optometrist may administer
and prescribe any drug authorized by the Texas Optometry Act, [
Sections
1.02 and 1.03
]
Articles 4552-1.02 and 1.03, as amended by House
Bill 1051, 76th Legislature, Regular Session.
Texas Civil Statutes,
Article 4542a-1)
], written prescriptions shall be on a form which contains
two signature lines of equal prominence, side by side, at the bottom of the
form. Under either signature line shall be printed clearly the words "product
selection permitted", and under the other signature line shall be printed
clearly the words "dispense as written." A therapeutic optometrist shall communicate
dispensing instructions to a pharmacist by signing on the appropriate line.
If the therapeutic optometrist does not clearly indicate that the prescription
drug shall be dispensed as ordered, the pharmacist may substitute a generically
equivalent drug product in compliance with the Texas Pharmacy Act.
certified
] therapeutic designation.
§4.04
]
§351.501 and §351.551.
Therapeutic ] Optometrists.
§5.09
]
§§351.155 and 351.403
. Any advertising
regarding services to be provided by [
a therapeutic
]
an
optometrist must not be false, deceptive, or misleading [
, and may state
"Certified as a Therapeutic Optometrist by the Texas Optometry Board."
].
Use of the term "board certified" or any similar word or phrase denoting
certification or specialization constitutes misleading or deceptive advertising
unless the advertising includes the name of the organization that has conferred
the certification or specialization. The Texas Optometry Board does not confer
certifications or specializations.
Part 23.
TEXAS REAL ESTATE COMMISSION