Transforming and Supporting Patient Care - Health Professions ...

318Chapter 13 – Profession of Optometryis not one of mild morbidity, or that requires a physician to take charge ofthe patient.In the United States, many states authorize optometrists to treat, by topicalor oral application, certain diseases or abnormal conditions of the humaneye and its adnexa with specific TPAs. Many states license diagnostic andtherapeutic classes of optometry, separating those who are educated andtrained in the use of pharmaceutical agents for diagnostic purposes, andthose who are trained in the use and prescribing of drugs for bothdiagnostic and therapeutic purposes. Typically, states impose limits on thedrugs which may be prescribed and require referral of a patient to amedical or osteopathic doctor when additional evaluation or treatment isnecessary. Few jurisdictions authorize medications given by injection orintravenously.Request 2: Classes or Lists of DrugsThe COO noted in its submission that it would prefer the designated drugregulation include classes of drugs, rather than lists of individual drugs.The use of classes permits optometrists to be able to access the mostappropriate and current drugs in a timely way. The COO states thatmembers will be expected to exercise professional judgment in selectingthe appropriate drug for diagnostic or treatment purposes, and will beexpected to be current with new drugs and best practices forpharmacotherapeutic interventions. The OAO said that Ontario educationalprograms are sufficient to support prescribing by class.The designated drugs regulation that the COO has put forward includesclasses of drugs, as well as some individual drugs. The COO explains that:The Designated Drugs Regulation that the College proposed doesinclude some specificity as to the purpose of oral anti-infective agents.The proposal includes “(oral) anti-infectives for the purpose of treatingcorneal and eyelid infections.” Certain classes of topically applied drugsincluded in the proposed regulation are obvious as to their purpose. Forinstance, “cycloplegics” and “artificial tears, ocular lubricants andsecretogogues” are quite obvious as to their purpose. Drugs in othercategories may be prescribed to treat multiple conditions.In the 2007 amendments to the Optometry Act, 1991, the legislation waschanged to enable drug regulations to include classes or categories ratherthan individual lists of drugs.Request 3: Prescribing Anti-Glaucoma DrugsOntario optometrists currently have no authority to prescribe antiglaucomadrugs. Optometrists must refer patients to a physician, usually anophthalmologist for treatment for glaucoma or high intraocular pressure.The COO has proposed approval in the designated drugs regulation of theaddition of four anti-glaucoma agents and one class of drugs to reduceintraocular pressure.HPRAC Critical Links January 2009