Be it enacted by the Senate and House of Representatives
in General Court assembled, and by the authority of the same,
SECTION 1. Chapter 13 of the General Laws is hereby amended by striking out section 16, as appearing in the 1984 Official Edition, and inserting in place thereof the following section:-
Section 16. There shall be a board of registration in optometry, in the following sections called the board, consisting of five members, citizens of the commonwealth to be appointed by the governor, four of whom shall have been engaged in the practice of optometry as defined in section sixty-six of chapter one hundred and twelve for the five years next preceding their appointment, and one of whom shall be a representative of the public, subject to the provisions of section nine B. One member shall annually, in September, be appointed by the governor for a term of five years. No member of the board shall be a stockholder of any school of optometry, a member of the faculty or on the board of trustees thereof, or financially interested in a manufacturing or wholesale optical business. No registered optometrist shall be appointed or reappointed to the board unless he is certified for use of diagnostic pharmaceutical agents under the provisions of section sixty-six A of said chapter one hundred and twelve.
SECTION 2. Paragraph (d) of section 7 of chapter 94C of the General Laws, as so appearing, is hereby amended by adding the following subparagraph:-
(10) a duly licensed optometrist who utilizes diagnostic pharmaceutical agents, as defined in section sixty-six A of chapter one hundred and twelve, and who qualifies to utilize such agents for the purpose of conducting an examination of the eye as provided in sections sixty-six A and sixty-eight A of chapter one hundred and twelve; provided, however, that a wholesale distributor or pharmacist may dispense such diagnostic pharmaceutical agents to a licensed optometrist for subsequent administration to optometry patients only if such optometrist provides the wholesale distributor or pharmacist with the number of the optometrist's certification of qualification to administer such diagnostic pharmaceutical agents.
SECTION 3. Chapter 112 of the General Laws is hereby amended by striking out section 66, as so appearing, and inserting in place thereof the following two sections:-
Section 66. The practice of optometry, as referred to in section sixty-seven to seventy-three, inclusive, shall mean the employment of any method or means, other than the use of drugs except as authorized under the provisions of sixty-six A, for the diagnosis of any optical defect, deficiency or deformity of the human eye or visual or muscular anomaly of the visual system or the adaptation or prescribing of lenses, prisms or ocular exercises for the correction, relief or aid of the visual functions.
Section 66A. Any registered optometrist qualified by examination for practice under the provisions of section sixty-eight subsequent to January first, nineteen hundred and eighty-four or duly certified in accordance with the provisions of section sixty-eight A may for the purpose of conducting an examination of the eye, and not for therapeutic purposes, utilize the topical application to the eye of diagnostic pharmaceutical agents; provided, however, that such diagnostic pharmaceutical agents shall not be administered to children under the age of four years or used in the examination of pseudophakes with intraocular lens implants.
For purposes of this section and sections sixty-eight and sixty-eight A, the term "diagnostic pharmaceutical agents" shall mean any topical anesthetic, mydriatic, or cyclopegic drug, except atropine and phenylephrine hydrochloride in ten per cent concentration, suitable for ocular examination procedures.
If during the course of examining a patient, the optometrist determines the existence of: (a) ocular pressure greater than twenty-four MM, or (b) any unexplained loss of visual field, or (c) a failure on the part of the individual being examined to achieve 20/40 or better corrected vision in each eye, or (d) signs of disease, the patient shall be referred to a licensed physician, unless such condition has been previously evaluated by a physician or unless the optometrist reports in writing that such referral is not warranted and documents the reasons therefor on the records of such patient.
SECTION 4. Said chapter 112 is hereby further amended by inserting after section 68, as so appearing, the following section:-
Section 68A. The board of registration in optometry shall annually administer an examination designed to measure the qualifications necessary in order to safely utilize the optical application of the diagnostic pharmaceutical agents provided for in section sixty-six A. Said examination shall be held in conjunction with the examination provided for in section sixty-eight and shall include any portion of the annual examination prepared by the National Board of Examiners in Optometry which covers the subject matter of pharmacology.
Such examination shall be open upon application to any optometrist registered under the provisions of this chapter and to any person who meets the qualifications for examination under section sixty-eight; provided, however, that each applicant shall furnish to the board satisfactory evidence of the completion of a qualifying course of study relating to the topical application to the eye of diagnostic pharmaceutical agents. Such a qualifying course of study shall be at a duly accredited medical school or college of optometry. The board shall, from time to time, adopt rules and regulations prescribing the content of said course of study; provided, however, that said course of study shall require a combined total of at least ninety-five hours of study and shall include the following areas of study or their equivalent:
(A) General pharmacology: four hours in biochemistry; eight hours in general physiology; eight hours in pharmacology; and ten hours in indications and ocular effects of commonly prescribed drugs.
(B) Ocular pharmacology: eight hours in ocular pharmacology and eight hours in the study of particular topically applied agents, including but not limited to, anesthetics, dyes, mydriatics, cyclopegics, and contact lens solutions.
(C) Interpretation and patient management: six hours each in the study of anterior and posterior segment; two hours in glaucoma; and one hour in ocular emergency.
(D) Cardiopulmonary resuscitation: four hours.
(E) Supervised clinical practice: thirty hours.
The board shall transmit to all successful applicants a certificate of qualification for the practice of optometry in accordance with the provisions of section sixty-six A.
SECTION 5. There is hereby established a special commission consisting of the commissioner of public health or his designee, the chairman of the board of registration in optometry or his designee, the chairman of the board of registration in medicine or his designee, one member of the Massachusetts School Nurses' Association, and one person from the general public, to study the use of diagnostic pharmaceutical agents by certified optometrists on children under the age of four years and in patients with pseudophakes. Said commission shall report the results of its study and its recommendations, if any, together with drafts of legislation necessary to carry its recommendations into effect, by filing the same with the clerk of the house of representatives on or before the last Wednesday in December, nineteen hundred and eighty-six.