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HARRISBURG, Pa.— Doctors of optometry in Pennsylvania, who have been working to win legislative approval for expanding their scope of practice for almost two decades, finally claimed victory late last month as the state approved new scope of practice regulations, according to the Pennsylvania Optometric Association (POA). Pennsylvania Gov. Tom Wolf on Oct. 29 signed Act 99 (House Bill 2561), an amendment to the state’s Optometric Practice and Licensure Act first passed in 1980, the association noted.

The amendment not only expands the ability of doctors of optometry to examine, diagnose and treat patients, but also gives the state board of optometry sole authority to set optometric formulary there. Patients, now seeing their eye doctors, will have greater access to needed medications, the association said.

“This legislation is a big win for optometry but, more importantly, for the citizens of Pennsylvania,” David Evans, OD, president of the Pennsylvania Optometric Association (POA), said in an announcement. The POA spearheaded the push for expanded scope.

“The POA has actively been pursuing improvement in its scope of practice for the past 18 years,” Dr. Evans said. “While other legislative victories have been achieved, our scope legislation has always faced fierce opposition.”
For many years, the POA said it found itself “playing defense against bills introduced by ophthalmology.” But circumstances came together correctly this year.

Dr. Evans credited experienced and passionate leadership on the POA’s legislative affairs committee—as half of its 16 members are past POA presidents—which worked diligently during difficult times to enhance the level of care Pennsylvania optometrists could provide the citizens of Pennsylvania. The committee also worked to develop and strengthen relationships with key legislators.

“This year, optometry in Pennsylvania was recognized during the pandemic as an ‘essential provider’ by our governor,” Dr. Evans added. “Our profession was on the front line for patient care during the stay-at-home order and beyond. Our key persons and members educated their legislators as to the vital role doctors of optometry play in the care of their constituents.”

What Act 99 does, according to the POA announcement: 

• Patients now have speedier access to medications by eliminating the need for the secretary of health to approve medications for inclusion on the optometric formulary.

• The scope of optometric practice has been clarified to explicitly state optometrists can use any and all means or methods for the examination, diagnosis and treatment of all conditions of the human visual system.

• The scope of optometric practice has been expanded to allow medical treatment of all forms of glaucoma, including the most sight threatening, closed-angle glaucoma.

• The scope of optometric practice has been expanded to permit treatment of dry eye and allergies without the need to consult with a licensed physician after six weeks of continuous treatment.

• The right to prescribe codeine, hydrocodone and their various combinations has been restored.

• The safety of optometric patients has been enhanced through the addition of the right to administer epinephrine auto injectors for the treatment of anaphylaxis.

• The right to order and interpret noninvasive angiography through the use of optical coherence tomography has been explicitly recognized.

• The Pennsylvania Board of Optometry has been given the exclusive right to manage and determine the optometric formulary.

• The right of optometric students to act as externs, under the supervision of a licensed optometrist, has been expanded to include students at all levels of optometric education.