California Code of Regulations › Title 16 - Professional and Vocational Regulations › Division 15 - State Board of Optometry › Article 11 - Therapeutic Pharmaceutical Agents › Section 1571 - Requirements for Glaucoma Certification

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Only optometrists meeting the
				requirements of this Article may apply for certification for the treatment of
				glaucoma as described in subdivision (j) of Section
				3041, in patients over 18 years of
				age. The optometrist shall:
(1) Hold an
				active license as an optometrist in California in good standing with the State
				Board of Optometry (Board);
(2) Be
				certified to use Therapeutic Pharmaceutical Agents (TPA) pursuant to Section
				3041.3;
(3) Complete a didactic course of no less
				than 24 hours in the diagnosis, pharmacological and other treatment and
				management of glaucoma. The following topics may be covered in the course:
(A) Anatomy and physiology of
				glaucoma
(B) Classification of
				glaucoma
(C) Pharmacology in
				glaucoma therapy
(D) Diagnosis of
				glaucoma including risk factors analysis
(E) Medical and surgical treatment
(F) Participant performance assessment;
				and
(4) Complete a Case
				Management Requirement where a minimum of 25 individual patients are each
				prospectively treated for a minimum of 12 consecutive months. For purposes of
				this section, "treat" means properly evaluating the patient, performing all
				necessary tests, diagnosing the patient, recognizing the type of glaucoma
				within a licensee's scope of practice, creating a treatment plan with proposed
				medications and target pressures, ongoing monitoring and reevaluation of the
				patient's condition, and making timely referrals to an ophthalmologist when
				appropriate. The following options may be chosen in any combination to fulfill
				this requirement:
(A) Case Management Course:
				Completion of a 16-hour case management course developed cooperatively by the
				accredited California schools and colleges of optometry and approved by the
				Board, with at least 15 cases of moderate to advanced complexity. The course
				may be conducted live, over the Internet, or by use of telemedicine. One hour
				of the program will be used for a final competency examination. Although the
				Case Management Course does not involve treatment of patients, completion of
				the 16-hour Case Management Course is equivalent to prospectively treating 15
				individual patients for 12 consecutive months. Therefore, completion of the
				16-hour Case Management Course will count as a 15-patient credit towards the
				Case Management Requirement. The full course must be completed to receive the
				15-patient credit. The course must include the following topics/conditions:
1. Presentation of conditions/cases that
				licensees may treat:
a. All primary open-angle
				glaucoma;
b. Exfoliation and
				pigmentary glaucoma.
2.
				Presentation of conditions/cases that licensees may not treat, but must
				recognize and refer to the appropriate physician and/or surgeon such as:
a. Pseudoglaucoma with vascular, malignant,
				or compressive etiologies;
b.
				Secondary glaucoma;
c. Traumatic
				glaucoma;
d. Infective or
				inflammatory glaucoma;
e.
				Appropriate evaluation and analysis for medical or surgical
				consultation;
f. In an emergency,
				if possible, stabilization of acute attack of angle closure and immediate
				referral of the patient.
(B) Grand Rounds Program: Completion of a
				16-hour grand rounds program developed cooperatively by the accredited
				California schools and colleges of optometry and approved by the Board, wherein
				participants will evaluate and create a management plan for live patients.
				Completion of the 16-hour Grand Rounds Program is equivalent to prospectively
				treating 15 individual patients for 12 consecutive months. Therefore, the
				16-hour Grand Rounds Program will count as a 15-patient credit towards the Case
				Management Requirement. The full program must be completed to receive the
				15-patient credit. Patients must be evaluated in person. The program must
				include the following:
1. Presentation of
				various patient types such as: glaucoma suspects; narrow angle, primary open
				angle glaucoma (early, moderate, late); and secondary open angle glaucoma such
				as pigment dispersion and pseudoexfoliation. Patient data, including but not
				limited to, visual acuities, intra-ocular pressures, visual fields, imaging,
				and pachymetry, will be available on-site and presented upon request;
2. Examination of patients, evaluation of
				data and test results, and commitment to a tentative diagnosis, treatment, and
				management plan;
3. Participation
				in group discussion of the cases with instructor feedback;
4. Attendance of follow-up meetings (within
				the 16-hour program requirement) where the same or different patients will be
				reviewed via serial data, including but not limited to visual fields and
				imaging photos.
(C)
				Preceptorship Program: Completion of a preceptorship program where each patient
				must be initially evaluated by the licensee and co-managed with a preceptor.
				Each patient must be prospectively treated for a minimum of 12 consecutive
				months. A preceptor for purposes of this section is defined as:
1. A California licensed, Board certified
				ophthalmologist in good standing; or
2. A California licensed optometrist in good
				standing, who has been glaucoma certified for two or more years.
Preceptors shall confirm the diagnosis and treatment plan,
				  and then approve the therapeutic goals and management plan for each patient.
				  Consultation with the preceptor must occur at appropriate clinical intervals or
				  when the therapeutic goals are not achieved. Clinical data will be exchanged at
				  appropriate intervals determined by the preceptor and the licensee.
				  Telemedicine and electronic exchange of information may be used as agreed upon
				  by the preceptor and the licensee. Each patient that is seen by the optometrist
				  in the program will count as a 1-patient credit towards the Case Management
				  Requirement.