852-080-0030 Conditions of Formulary Application The following conditions apply to the formulary of pharmaceutical agents in 852-080-0020 and 852-080-0025: (1) Optometric physicians certified for Topical Therapeutic Pharmaceutical Agents (TPA), Nontopical Therapeutic Pharmaceutical Agents (AT) or Nontopical Therapeutic Pharmaceutical Agents with Injections (ATI) may use, administer, and prescribe any and all over-the-counter pharmaceutical agents. (2) Optometric physicians certified for topical TPA use may use, administer and prescribe topical agents in Categories 1-16. (3) Optometric physicians certified for nontopical TPA use have the designation “AT” or “ATI” printed on their licenses, and may use, administer and prescribe topical and nontopical agents in Categories 1-24 as indicated for procedures that are permitted under OAR Chapter 852, Division 20 Standards of Optometric Practice. (4) Glaucoma Treatment: (a) Optometric physicians treating a patient with antiglaucoma medication must consult with an ophthalmologist if: (A) The glaucoma progresses despite the use of two glaucoma medications; (B) More than two medications are required to control the glaucoma; or (C) A secondary glaucoma develops; (b) Glaucoma is considered to be progressing if, in comparison to prior examinations, there is a reproducible worsening of the patient’s visual field as measured by standard threshold testing or if there is a worsening of the patient’s optic nerve as measured by direct observation or standard imaging technology or by rising eye pressure despite the use of two or more medications; (c) Glaucoma is considered to be under control if target eye pressure, individualized for each patient, is maintained with no abnormal glaucomatous progression; and (d) A combination medication that contains two pharmacologic agents is considered one medication. (5) Optometric physicians certified for nontopical TPA must consult with a doctor of medicine or doctor of osteopathy, licensed under ORS Chapter 677, before extending treatment with nontopical corticosteriods or Schedule III analgesics beyond seven days. (6) Optometric physicians should be diligent in preventing the diversion of drugs for illegitimate purposes. Upon application, active status licensees are granted access to the Oregon Prescription Drug Monitoring Program of the Oregon Health Authority to research controlled substance information on their patients; under ORS Chapter 431, fees for the program are required to be collected at the time of annual active license renewal by the Board and allow doctors to register and use the program at no additional charge. (7) Optometric physicians may not use, administer or prescribe agents classified principally as anti-neoplastics. (8) Optometric physicians may use or administer pharmaceutical agents in cases of emergency requiring immediate attention. (9) Optometric physicians certified for nontopical TPA with injections (ATI) use may administer subcutaneous and subconjunctival injections. Sub-Tenon, retrobulbar, intraocular and botulinum toxin injections are excluded. (10) Optometric physicians certified for nontopical TPA use, may administer oral pre-medication for light sedation. Conscious sedation, deep sedation and general anesthesia are excluded. (11) Optometric physicians certified for topical or nontopical TPA use may prescribe and dispense therapeutic contact lenses that include pharmaceutical agents listed on the topical formulary in OAR 852-80-0020. Statutory/Other Authority: ORS 683 & 182 Statutes/Other Implemented: ORS 683.240, 683.270 & 182.466 History: OPT 1-2013, f. & cert. ef. 1-3-13 OPT 1-2008, f. 6-25-08, cert. ef. 7-1-08 OPT 2-2007, f. 12-7-07 & cert. ef. 1-1-08 OPT 2-2006, f. 3-20-06, cert. ef. 4-1-06 OPT 1-2002, f. & cert. ef. 7-26-02 OPT 1-2000, f. & cert. ef. 3-15-00 OPT 4-1998, f. 6-25-98, cert. ef. 7-1-98 OP 1-1994, f. 5-4-94, cert. ef. 5-9-94