H.F. 2248 Section 1. Section 147.108, subsection 2, Code 2011, is 1 amended to read as follows: 2 2. After contact lenses have been adequately adapted and 3 the patient released from initial follow-up care by a person 4 licensed under chapter 148 or 154 , the patient may request 5 a copy, at no cost, of the contact lens prescription from 6 that licensed person. A person licensed under chapter 148 or 7 154 shall not withhold a contact lens prescription after the 8 requirements of this section have been met. The prescription, 9 at the option of the prescriber, may be given orally only to a 10 person who is actively practicing and licensed under chapter 11 148 , 154 , or 155A . The contact lens prescription shall contain 12 an expiration date, at the discretion of the prescriber, but 13 not to exceed eighteen months. The contact lens prescription 14 shall contain the necessary requirements of the ophthalmic 15 lens, and the prescription validation requirements as defined 16 by rules adopted pursuant to this section . The prescription 17 may contain adapting and material guidelines and may also 18 contain specific instructions for use by the patient. For 19 the purpose of this section , “ophthalmic lens” means one which 20 has been fabricated to fill the requirements of a particular 21 contact lens prescription, including pharmaceutical-delivering 22 contact lenses as defined in section 154.1, subsection 4 3 . 23 Sec. 2. Section 154.1, Code 2011, is amended to read as 24 follows: 25 154.1 Board defined —— optometry —— diagnostically certified 26 licensed optometrists —— therapeutically certified optometrists 27 licensed optometrists . 28 1. As used in this chapter , “board” means the board of 29 optometry created under chapter 147 . 30 2. For the purpose of this subtitle, the following classes 31 of persons shall be deemed to be engaged in the practice of 32 optometry: 33 a. Persons employing any means other than the use of drugs, 34 medicine, or surgery for the measurement of the visual power 35 -1- LSB 5303HV (1) 84 jr/nh 1/ 5

H.F. 2248 and visual efficiency of the human eye; persons engaged in 1 the prescribing and adapting of lenses, prisms, and contact 2 lenses; and persons engaged in the using or employing of visual 3 training or ocular exercise for the aid, relief, or correction 4 of vision ; and persons employing the use of medicines and 5 procedures for the purposes of diagnosis and treatment of 6 diseases or conditions of the eye and adnexa . 7 b. Persons who allow the public to use any mechanical device 8 for a purpose described in paragraph “a” . 9 c. Persons who publicly profess to be optometrists and to 10 assume the duties incident to the profession. 11 3. Diagnostically certified licensed optometrists may 12 employ cycloplegics, mydriatics, and topical anesthetics as 13 diagnostic agents topically applied to determine the condition 14 of the human eye for proper optometric practice or referral 15 for treatment to a person licensed under chapter 148 . A 16 diagnostically certified licensed optometrist is an optometrist 17 who is licensed to practice optometry in this state and who is 18 certified by the board to use diagnostic agents. 19 4. 3. a. Therapeutically certified optometrists An 20 optometrist licensed under this chapter may employ all 21 diagnostic and therapeutic pharmaceutical agents for the 22 purpose of diagnosis and treatment of conditions of the human 23 eye and adnexa pursuant to this subsection , excluding the 24 use of injections other than to counteract an anaphylactic 25 reaction, and notwithstanding section 147.107 , may without 26 charge supply any of the above pharmaceuticals to commence a 27 course of therapy. A licensed optometrist may perform minor 28 surgical procedures and use medications for the diagnosis and 29 treatment of diseases, disorders, and conditions of the eye and 30 adnexa. A license to practice optometry under this chapter 31 does not authorize the performance of surgical procedures 32 which require the use of injectable or general anesthesia or 33 penetration of the globe or the use of ophthalmic lasers for 34 the purpose of ophthalmic surgery within or upon the globe. 35 -2- LSB 5303HV (1) 84 jr/nh 2/ 5

H.F. 2248 b. Therapeutically certified optometrists A licensed 1 optometrist may employ and, notwithstanding section 147.107 , 2 supply pharmaceutical-delivering contact lenses for the 3 purpose of treatment of conditions of the human eye and adnexa. 4 For purposes of this paragraph, “pharmaceutical-delivering 5 contact lenses” means contact lenses that contain one or more 6 therapeutic pharmaceutical agents authorized for employment 7 by this section for the purpose of treatment of conditions of 8 the human eye and adnexa and that deliver such agents into the 9 wearer’s eye. 10 c. Therapeutically certified optometrists A licensed 11 optometrist may prescribe oral steroids for a period not to 12 exceed fourteen days without consultation with a physician. 13 Therapeutically certified optometrists shall not prescribe oral 14 Imuran or oral Methotrexate. 15 d. Therapeutically certified optometrists A licensed 16 optometrist may be authorized, where reasonable and 17 appropriate, by rule of the board, to employ new diagnostic and 18 therapeutic pharmaceutical agents approved by the United States 19 food and drug administration on or after July 1, 2002, for the 20 diagnosis and treatment of the human eye and adnexa. 21 e. The board shall is not be required to adopt rules 22 relating to topical pharmaceutical agents, oral antimicrobial 23 agents, oral antihistamines, oral antiglaucoma agents, and 24 oral analgesic agents. Superficial A licensed optometrist may 25 remove superficial foreign bodies may be removed from the human 26 eye and adnexa. 27 f. The therapeutic efforts of a therapeutically certified 28 licensed optometrist are intended for the purpose of 29 examination, diagnosis, and treatment of visual defects, 30 abnormal conditions, and diseases of the human eye and adnexa, 31 for proper optometric practice or referral for consultation or 32 treatment to persons licensed under chapter 148 . 33 g. A therapeutically certified licensed optometrist is 34 an optometrist who is licensed to practice optometry in this 35 -3- LSB 5303HV (1) 84 jr/nh 3/ 5

H.F. 2248 state and who is certified by the board to use the agents and 1 procedures authorized pursuant to this subsection . 2 5. 4. Beginning July 1, 2012, all licensed optometrists 3 shall meet requirements established by the board by rule to 4 employ diagnostic and therapeutic pharmaceutical agents for the 5 practice of optometry. All licensees practicing optometry in 6 this state shall have demonstrated qualifications and obtained 7 certification to use diagnostic and therapeutic pharmaceutical 8 agents as a condition of license renewal. 9 Sec. 3. Section 154.10, Code 2011, is amended to read as 10 follows: 11 154.10 Standard of care. 12 1. A diagnostically certified licensed optometrist 13 employing diagnostic pharmaceutical agents as authorized by 14 section 154.1 shall be held to the same standard of care in the 15 use of such agents and in diagnosis as is common to persons 16 licensed under chapter 148 in this state. 17 2. A therapeutically certified person licensed as an 18 optometrist employing pharmaceutical agents as authorized 19 by section 154.1 pursuant to this chapter shall be held to 20 the same standard of care in the use of such agents and in 21 diagnosis and treatment as is common to persons licensed under 22 chapter 148 in this state. 23 Sec. 4. Section 155A.21, subsection 2, Code 2011, is amended 24 to read as follows: 25 2. Subsection 1 does not apply to a licensed pharmacy, 26 licensed wholesaler, physician, veterinarian, dentist, 27 podiatric physician, therapeutically certified optometrist, 28 advanced registered nurse practitioner, physician assistant, 29 a nurse acting under the direction of a physician, or the 30 board of pharmacy, its officers, agents, inspectors, and 31 representatives, or to a common carrier, manufacturer’s 32 representative, or messenger when transporting the drug or 33 device in the same unbroken package in which the drug or device 34 was delivered to that person for transportation. 35 -4- LSB 5303HV (1) 84 jr/nh 4/ 5

H.F. 2248 EXPLANATION 1 Under current law, only an optometrist who has been 2 therapeutically certified by the board of optometry can employ 3 all diagnostic and therapeutic pharmaceutical agents for the 4 purpose of diagnosis and treatment of conditions of the human 5 eye and adnexa. This bill eliminates the requirements for 6 special certification. 7 Current law also requires that beginning July 1, 2012, all 8 licensed optometrists shall meet requirements established 9 by the board by rule to employ diagnostic and therapeutic 10 pharmaceutical agents for the practice of optometry. All 11 licensees practicing optometry in this state shall have 12 demonstrated qualifications and obtained certification to use 13 diagnostic and therapeutic pharmaceutical agents as a condition 14 of license renewal. 15 -5- LSB 5303HV (1) 84 jr/nh 5/ 5