2023 New York Laws › EDN - Education › Title 8 - The Professions › Article 143 - Optometry › 7101-A - Certification to Use Therapeutic Drugs.

§ 7101-a. Certification  to  use therapeutic drugs. 1. Definitions. As
used in this section, the  following  terms  shall  have  the  following
meanings:
(a)  Clinical  training.  Clinical  training shall mean the diagnosis,
treatment and management of patients with ocular disease  and  shall  be
comparable  to  that  acquired  by  a  current  graduate  of  the  State
University College of Optometry.
(b) Consultation.  Consultation  shall  mean  a  confirmation  of  the
diagnosis, a plan of co-management of the patient, and a periodic review
of the patient's progress.
(c)  Education review committee. Education review committee shall mean
the committee established pursuant to subdivision nine of this section.
(d) Diagnostic pharmaceuticals. Diagnostic pharmaceuticals shall  mean
those  drugs  which  shall  be  limited  to  topical applications to the
surface of the eye for the purpose of diagnostic examination of the  eye
and shall be limited to:
(i) Anesthetic agents;
(ii) Mydriatics;
(iii) Cycloplegics;
(iv) Miotics;
(v)  Disclosing  agents  and other substances used in conjunction with
these drugs as part of a diagnostic procedure.
(e) Topical therapeutic  pharmaceutical  agents.  Topical  therapeutic
pharmaceutical  agents  shall mean those drugs which shall be limited to
topical application to the surface of the eye for  therapeutic  purposes
and shall be limited to:
(i) antibiotic/antimicrobials;
(ii) decongestants/anti-allergenics;
(iii) non-steroidal anti-inflammatory agents;
(iv) steroidal anti-inflammatory agents;
(v) antiviral agents;
(vi) hyperosmotic/hypertonic agents;
(vii) cycloplegics;
(viii) artificial tears and lubricants; and
(ix) immunosuppressive agents.
(f)  Therapeutic  pharmaceutical  agents for treatment of glaucoma and
ocular hypertension. Therapeutic pharmaceutical agents for treatment  of
glaucoma  and  ocular hypertension shall mean those drugs which shall be
limited to topical application to the surface of the eye  and  shall  be
limited to:
(i) beta blockers;
(ii) alpha agonists;
(iii) direct acting cholinergic agents;
(iv) prostaglandin analogs; and
(v) carbonic anhydrase inhibitors.
(g)   Oral   therapeutic   pharmaceutical   agents.  Oral  therapeutic
pharmaceutical agents shall mean those orally  administered  drugs  used
for therapeutic purposes solely for the treatment of diseases of the eye
and adnexa and shall be limited to:
(i) the following antibiotics:
(1) amoxicillin/clavulanate potassium;
(2) cephalexin;
(3) azithromycin;
(4) sulfamethoxazole/trimethoprim;
(5) doxycycline; and
(6) tetracycline;
(ii)  the  following  antiglaucoma  agents  used for the management of
acute  increases  in  intraocular  pressure;   provided,   however,   an

optometrist  may  use  or  prescribe  a  maximum of one twenty-four hour
prescription and shall immediately  refer  the  patient  to  a  licensed
physician specializing in diseases of the eye:
(1) acetazolamide; and
(2) methazolamide; and
(iii)   the   following   antiviral  agents  used  for  herpes  zoster
ophthalmicus; provided an optometrist shall use or prescribe in maximum,
one seven-day prescription; provided, however, if a patient is diagnosed
with herpes zoster ophthalmicus and has not already been examined  by  a
primary  care  physician  or  other appropriate physician for such viral
condition, an optometrist shall refer the patient to a licensed  primary
care  physician, licensed physician specializing in diseases of the eye,
or other appropriate physician within three days of such diagnosis:
(1) valacyclovir; and
(2) acyclovir.
2. Standard of care. An optometrist authorized to  use  pharmaceutical
agents  for  use  in  the  diagnosis,  treatment or prevention of ocular
disease shall be held to the same standard of care in diagnosis, use  of
such  agents,  and  treatment  as  that  degree of skill and proficiency
commonly exercised by a physician in the same community.
3. Certificate. The commissioner shall issue appropriate  certificates
to   use  therapeutic  pharmaceutical  agents  in  accordance  with  the
provisions of this section to those optometrists who have satisfactorily
completed a curriculum in general and ocular pharmacology at  a  college
of  optometry with didactic and supervised clinical programs approved by
the department are eligible to apply for the certificate issued pursuant
to this section.
4. Topical therapeutic pharmaceutical  agents.  (a)  Before  using  or
prescribing  topical therapeutic pharmaceutical agents, each optometrist
shall have completed at least three hundred hours of  clinical  training
in  the  diagnosis,  treatment  and  management  of patients with ocular
disease other than glaucoma and  ocular  hypertension,  not  fewer  than
twenty-five  hours of such training shall have been completed subsequent
to June thirtieth, nineteen hundred ninety-three and additionally  shall
either  have  taken and successfully passed the treatment and management
of ocular diseases  portion  of  the  National  Board  of  Examiners  in
Optometry  test  or  have  taken  and successfully passed an examination
acceptable to the board.
(b) Before using or prescribing therapeutic pharmaceutical agents  for
treatment  of  glaucoma  and ocular hypertension, an optometrist must be
certified  for  diagnostic  and  topical  therapeutic  agents  and  have
completed  an  additional  one hundred hours of clinical training in the
diagnosis, treatment and management of patients with glaucoma and ocular
hypertension, not fewer than twenty-five hours of  such  training  shall
have   been   completed  subsequent  to  July  first,  nineteen  hundred
ninety-four, and shall have taken and successfully  passed  an  oral  or
written examination acceptable by the board.
(c)  Before  using  or  prescribing  oral  therapeutic  pharmaceutical
agents,  an  optometrist  must  be  certified  to  prescribe  diagnostic
pharmaceutical   agents   and   topical   therapeutic   and  therapeutic
pharmaceutical agents for treatment of glaucoma and ocular hypertension,
have completed an oral therapeutic  pharmaceutical  agent  certification
course  and  have  passed  an  examination  within  five  years  of  the
department's approval of the initial certification course or the initial
examination, whichever is later provided, however,  an  optometrist  who
has  commenced  the  oral therapeutic pharmaceutical agent certification
course within the five year time  period  but  has  not  yet  passed  an
examination  shall  be  allowed  to  take  such  examination  and become

certified after the five year time period provided for in this paragraph
has ended.
(i)  The  curriculum  for  the  oral  therapeutic pharmaceutical agent
certification course shall include, but not be limited  to,  instruction
in  pharmacology  and drug interaction in treating ocular disease and be
taught through clinical case scenarios and emphasize  clinical  decision
making  and  shall  be  no  less than forty hours, of which no less than
twenty-four hours shall be live instruction.
(ii)  Such  course  shall  qualify  towards  meeting  the   continuing
education per triennial registration requirement pursuant to subdivision
seven of this section.
(iii)  The  examination shall assess the knowledge of materials in the
curriculum  and  reflect  the  oral  therapeutic  pharmaceutical  agents
described in paragraph (g) of subdivision one of this section, and shall
be acceptable to the department.
(iv) The initial, and any subsequent, curriculum and examination shall
be subject to review and approval by the department.
(v)  The  requirement  for  the  oral therapeutic pharmaceutical agent
certification  course  and  examination  shall  not   apply   to   those
optometrists  who  graduated  from  an  accredited  college of optometry
subsequent to January first, two thousand twenty-two and have taken  and
successfully  passed  the  National  Board  of  Examiners  in  Optometry
examination or an examination acceptable to the department.
(d) The clinical training required  by  this  section  may  have  been
acquired  prior  to  the enactment of this section not inconsistent with
paragraphs (a) and (b) of this subdivision. Approval of the pre-acquired
clinical training shall be in accordance with subdivision nine-a of this
section.
(e) The provisions of paragraphs (a) and (b) of this subdivision shall
not apply to (i) graduates of an appropriate  program  approved  by  the
department  who  have  successfully passed the examination on the use of
diagnostic and therapeutic drugs and who graduated subsequent to January
first, nineteen hundred ninety-three; or (ii) optometrists who have been
certified for at least five years to use phase one and phase  two  drugs
in  another  jurisdiction,  have  demonstrated such use in independently
managed patients, and have been  licensed  in  accordance  with  section
seventy-one   hundred  four  of  this  chapter.  Provided,  however,  no
optometrist exempt under this paragraph shall be permitted to use  phase
one   therapeutic   pharmaceutical   agents  or  phase  two  therapeutic
pharmaceutical agents prior to the  general  authorization  provided  to
optometrists licensed in this state.
5.  Suspension  of  certification.  The  department  shall suspend the
certification for the use and prescribing of topical therapeutic  agents
of  any  optometrist  who fails to receive certification for therapeutic
pharmaceutical agents for treatment of glaucoma and ocular  hypertension
within  three  years  of  having  been certified for topical therapeutic
pharmaceutical agents.
6. Consultation with use of certain topical therapeutic pharmaceutical
agents for treatment of glaucoma and ocular hypertension.  (a) After the
initial  diagnosis  of  glaucoma  or  ocular  hypertension  and   before
initiating  treatment  of  any patient, an optometrist shall engage in a
written consultation with a licensed physician specializing in  diseases
of the eye.
(b)  A  consultation  shall be required for a period of three years or
until the optometrist has examined and diagnosed  seventy-five  patients
having  glaucoma  or  ocular  hypertension  which examinations require a
written  consultation  in  accordance  with  paragraph   (a)   of   this
subdivision, whichever occurs later.
(c)  The  consultation  provisions shall not apply to a graduate of an
appropriate program approved by the department who  successfully  passed
an  examination  in the use of diagnostic and therapeutic pharmaceutical
agents approved by the department and graduated such  school  subsequent
to  January first, nineteen hundred ninety-nine and who has had at least
seventy-five documented examinations  and  diagnosis  of  patients  with
glaucoma  or  ocular  hypertension which examinations were part of their
training and were under physician supervision.
7. Continuing education. (a) Each optometrist certified to use topical
therapeutic pharmaceutical agents and therapeutic pharmaceutical  agents
for  treatment  of  glaucoma  and  ocular hypertension, shall complete a
minimum of thirty-six hours of  continuing  education  in  the  area  of
ocular  disease and pharmacology per triennial registration period. Each
optometrist certified to  use  oral  therapeutic  pharmaceutical  agents
shall,  in  addition  to  the  minimum  thirty-six  hours  of continuing
education provided for  in  this  subdivision,  complete  an  additional
minimum  of  eighteen  hours of continuing education related to systemic
disease and therapeutic treatment  per  triennial  registration  period.
Such  educational  programs  may  include  both  didactic  and  clinical
components and shall be approved in advance by the department. Beginning
on January first, two thousand twenty-three, all sponsors of  continuing
education  courses  seeking  advanced approval from the department shall
file an application and pay  a  fee  determined  by  the  department  in
accordance  with  the  regulations  of  the commissioner. An optometrist
subject to the provisions of this subdivision whose  first  registration
date following the effective date of this section occurs less than three
years  from  such  effective  date,  but  on or after January first, two
thousand twenty-three, shall complete continuing education  hours  on  a
prorated  basis  at  the  rate  of  one  hour  per  month for the period
beginning January first, two  thousand  twenty-three  up  to  the  first
registration  date  thereafter. An optometrist who has not satisfied the
mandatory continuing education requirement pursuant to this  subdivision
shall  not  be  issued  a  triennial  registration  certificate  by  the
department and  shall  not  practice  unless  and  until  a  conditional
registration  is  issued  as  provided  for  in  paragraph  (b)  of this
subdivision. Continuing education hours taken during one  triennium  may
not be transferred to the subsequent triennium.
(b)  The  department,  in  its  discretion,  may  issue  a conditional
registration  to  an  optometrist  who  fails  to  meet  the  continuing
education requirements established in paragraph (a) of this subdivision,
but  who  agrees to make up any deficiencies and complete any additional
education  which  the  department  may  require.  The  fee  for  such  a
conditional  registration  shall be the same as, and in addition to, the
fee for the triennial registration. The  duration  of  such  conditional
registration shall be determined by the department, but shall not exceed
one  year. Any optometrist who is notified of the denial of registration
for failure to submit  evidence,  satisfactory  to  the  department,  of
required   continuing   education   and   who   practices  without  such
registration may be subject  to  disciplinary  proceedings  pursuant  to
section sixty-five hundred ten of this title.
(c)  In  accordance with the intent of this section, adjustment to the
mandatory  continuing  education  requirement  may  be  granted  by  the
department  for  reasons  of health that are certified by an appropriate
health care professional, for extended active duty with the armed forces
of the United  States,  or  for  other  good  cause  acceptable  to  the
department which may prevent compliance.
(d)  An  optometrist  not  engaged  in  practice, as determined by the
department, shall be exempt  from  the  mandatory  continuing  education

requirement upon the filing of a statement with the department declaring
such  status.  Any  licensee  who  returns  to the practice of optometry
during the triennial registration period  shall  notify  the  department
prior  to  reentering  the  profession  and  shall  meet such continuing
education requirements as shall be  prescribed  by  regulations  of  the
commissioner.
(e)  Optometrists  subject to the provisions of this subdivision shall
maintain adequate documentation of completion of  acceptable  continuing
education credits and shall provide such documentation at the request of
the  department.  Failure to provide such documentation upon the request
of the department shall be an act of misconduct subject to  disciplinary
proceedings pursuant to section sixty-five hundred ten of this title.
(f)  The mandatory continuing education fee shall be determined by the
department. Such fee shall be payable on or before the first day of each
triennial registration period, and shall be  paid  in  addition  to  the
triennial  registration  fee  required  by  subdivision eight of section
seventy-one hundred four of this article.
8.  Notice  to  patient  with  the  use  or  prescription  of  topical
therapeutic  pharmaceutical agents and therapeutic pharmaceutical agents
for  treatment  of  glaucoma  and  ocular  hypertension.  (a)   (i)   An
optometrist  prescribing  topical steroids or antiviral medication shall
inform each patient that in the event the  condition  does  not  improve
within five days, a physician of the patient's choice will be notified.
(ii)  An  optometrist  engaged  in  a  written  consultation  with  an
ophthalmologist shall inform a patient diagnosed with glaucoma that  the
optometrist  will  have  the  diagnosis confirmed and co-managed with an
ophthalmologist  of  the  patient's  choice,  or  one  selected  by  the
optometrist.
(b)  In  addition,  each  optometrist  certified  to prescribe and use
therapeutic  drugs  shall  have  posted  conspicuously  in  the   office
reception area the following notice:
"Dr.  (Name),  O.D.  is  certified  by  New York State to use drugs to
diagnose and treat diseases of the eye.  In  the  event  your  condition
requires  the use of steroids or antiviral medication and your condition
does not improve within five days, a physician of your  choice  will  be
notified.
In  the  event  you  are diagnosed with glaucoma, the optometrist will
have  your  diagnosis  confirmed  and  treatment  co-managed   with   an
ophthalmologist (MD) of your choice, or if you wish, one selected by Dr.
(Name)."
The  second  paragraph  of  such  notice  shall only be required to be
included during the period when the optometrist is engaged in a  written
consultation pursuant to subdivision six of this section.
9. Education review committee. An education review committee is hereby
created to advise and assist the commissioner in evaluating pre-acquired
clinical  training.  The  members of the committee shall be appointed by
the commissioner in  consultation  with  the  chancellor  of  the  state
university of New York. The committee shall consist of five members, two
of  whom  shall  be  optometrists  on the faculty of the SUNY college of
optometry, two of whom shall be ophthalmologists  who,  in  addition  to
being  members  of  the  faculty  of any approved medical school in this
state and not also faculty members of SUNY college  of  optometry,  have
surgical  privileges  at a New York state hospital. The fifth member who
shall be designated as chair shall be an expert in the field  of  public
health and shall be neither an ophthalmologist nor an optometrist.
The  commissioner  shall  submit each application to the committee for
its review  and  recommendation.  In  making  such  recommendation,  the
committee  shall  advise  as  to  the  number  of  hours of pre-acquired

clinical training, if any, to be approved, based  upon  the  information
submitted  with  the  application.  In  evaluating  such  training,  the
committee  shall  be  authorized  to  require  the  submission  of  such
reasonable  documentation needed to facilitate the committee's review of
the adequacy and relevance of such training.
9-a. Pre-acquired clinical training. (a) Each  optometrist  requesting
approval  of  pre-acquired  clinical  training  shall  submit  a written
application to the department. The commissioner,  in  consultation  with
the education review committee may provide credit for the following:
(i)  clinical  training  acquired  at  an  institution accredited by a
regional or professional accreditation organization which is  recognized
or approved by the United States Department of Education, the department
and the Board of Regents of the University of the state of New York;
(ii) clinical training acquired at a facility licensed by the state of
New  York  in  accordance with article twenty-eight of the public health
law or at a comparable facility located  in  another  state  or  country
provided  the  licensing  requirements  or accreditation requirements of
such institution are comparable to those of New York state;
(iii) hospital affiliations, including rounds and  patient  management
for applicants having staff privileges at such facility;
(iv)  consultation and co-management with ophthalmologists of patients
with ocular disease and post-surgery recovery;
(v) postdoctoral accredited residency or fellowship programs;
(vi) experience at an accredited educational institution as a  faculty
instructor   in   clinical   practice,  ocular  disease  management  and
pharmacology;
(vii) experience in other states  in  which  the  applicant  has  been
certified to use therapeutic pharmaceutical agents.
(b)  Any  optometrist  disagreeing  with  the  recommendation  of  the
education review committee shall have a right to appeal  in  writing  to
the  commissioner.  The  decision of the commissioner shall be final and
binding on all parties.
10. Pharmaceutical agents. Optometrists who  have  been  approved  and
certified  by  the  department  shall  be permitted to use the following
drugs:
(a) Diagnostic pharmaceuticals.
(b) Those optometrists having been certified for  topical  therapeutic
pharmaceutical  agents  shall  be  authorized  to  use and prescribe all
topical therapeutic pharmaceutical agents specified in paragraph (e)  of
subdivision one of this section, which are FDA approved and commercially
available for topical use.
In the event an optometrist treats a patient with topical antiviral or
steroidal  drugs  and the patient's condition either fails to improve or
worsens within five days,  the  optometrist  shall  notify  a  physician
designated by the patient or, if none, by the treating optometrist.
(c)   Those   optometrists   having  been  certified  for  therapeutic
pharmaceutical agents for treatment of glaucoma and ocular  hypertension
shall  be  authorized  to  use  and prescribe therapeutic pharmaceutical
agents for treatment of glaucoma and ocular  hypertension  specified  in
paragraph (f) of subdivision one of this section, which are FDA approved
and commercially available.
(d)  Those  optometrists  having  been  certified for oral therapeutic
pharmaceutical agents shall be authorized  to  use  and  prescribe  oral
therapeutic   pharmaceutical   agents  specified  in  paragraph  (g)  of
subdivision one of this section, which are FDA approved and commercially
available and shall comply with all safety information  and  side-effect
and  warning  advisories  contained in the most current physicians' desk
reference.
(e) Those optometrists having been certified for  topical  therapeutic
pharmaceutical  agents,  therapeutic pharmaceutical agents for treatment
of glaucoma and ocular hypertension or oral  therapeutic  pharmaceutical
agents  shall  be  authorized  to  use and recommend all nonprescription
medications,  whether  intended for topical or oral use, appropriate for
the treatment of the eye and adnexa.
11. Responsibilities of the commissioner. The commissioner shall adopt
regulations (a) providing for  the  certification  of  graduates  of  an
appropriate  program  approved  by  the department who have successfully
passed  the  examination  on  the  use  of  diagnostic  and  therapeutic
pharmaceutical  agents  and  who  have  graduated  subsequent to January
first,  nineteen  hundred  ninety-three;  and  (b)  providing  for   the
certification  of  optometrists who have graduated from other accredited
colleges  of  optometry  or  who  are  licensed  to  practice  in  other
jurisdictions,  have  demonstrated  such  use  in  independently managed
patients and are seeking licensure and certification in New York.
12. Responsibilities of the commissioner of health.  The  commissioner
of  health  may  recommend to the commissioner additions or deletions to
the department's regulations relating to optometric use of drugs  except
that  such recommendations shall be limited only to additions which have
been determined to be equivalent to those drugs  already  authorized  or
deletions  based upon a finding that the drugs are no longer appropriate
for their current use or for other similar reasons.