Sec. 20-127. Definitions. Scope of practice. License renewal forms.
Sec. 20-127. Definitions. Scope of practice. License renewal forms. (a) For the
purposes of this chapter:
(1) The "practice of advanced optometric care" means any one or more of the following practices and procedures: (A) Measuring, examining, diagnosing, preventing, enhancing, managing or treating visual functions, defects of vision, muscular functions
or anomalies, or other conditions or diseases of the visual system, the eye and ocular
adnexae; (B) the prescribing, supplying, adjusting, fitting or adapting of ophthalmic
devices and lenses, spectacles, prisms, orthoptic therapy, visual therapy, visual rehabilitation, oculomotor therapy, tinted lenses, filters, contact lenses, diagnosing, preventing,
enhancing, managing, treating or relieving visual functions, defects of vision, muscular
functions or anomalies, or diseases of the visual system, the eye and ocular adnexae;
(C) the administration or prescription of any pharmaceutical agents related to the diagnosis and treatment of conditions and diseases of the eye and ocular adnexae, excluding
nonemergency oral glaucoma agents but including controlled substances under schedules II, III, IV and V in accordance with section 21a-252, subject to the limitations of
subsection (f) of this section relating to quantities dispensed, performance or ordering
of procedures or laboratory tests related to the diagnosis and treatment of conditions
and diseases of the eye and ocular adnexae; these procedures include, but are not limited
to, removal of superficial foreign bodies of the cornea, ultrasound and topical, oral
or injectable medication to counteract anaphylaxis or anaphylactic reaction; (D) the
nonsurgical treatment of glaucoma consistent with subsection (k) of this section; or (E)
the use of punctal plugs. The "practice of advanced optometric care" does not include
surgical treatment of glaucoma, treatment of ocular cancer, treatment of infectious diseases of the retina, diagnosis and treatment of systemic diseases, use of therapeutic
lasers, use of injectable medications other than to counteract anaphylaxis or anaphylactic
reaction, surgical procedures other than noninvasive procedures, use of general anesthesia, use of intravenous injections, procedures that require the cutting or opening of the
globe, enucleation of the eye, extraocular muscle surgery or any invasive procedure
performed on the human body other than noninvasive procedures performed on the eye
or ocular adnexae.
(2) "Optometrist" means an individual licensed pursuant to this chapter to engage
in the practice of optometry.
(3) The "practice of optometry" means any one or more of the following practices
and procedures: (A) The examination of the human eye and the eyelid for the purpose
of diagnosis, treatment excluding the lacrimal drainage system and lacrimal gland or
referral for consultation, as authorized by this section or, where appropriate, referral to
an ophthalmologist; (B) the use of tests, instruments, devices, ocular agents-D, ocular
agents-T and noninvasive procedures for the purpose of investigation, examination,
diagnosis, treatment excluding the lacrimal drainage system and lacrimal gland, or correction, as authorized by this section, of visual defects, abnormal conditions or diseases
of the human eye and eyelid; (C) the prescription and application of ophthalmic lenses,
prisms, filters, devices containing lenses or prisms or filters or any combination thereof,
orthoptics, vision training, ocular agents-D for the purpose of diagnosing visual defects,
abnormal conditions or diseases of the human eye and eyelid, ocular agents-T and noninvasive procedures for the purpose of correction, alleviation or treatment, as authorized
by this section, of visual defects, abnormal conditions or diseases of the human eye and
eyelid excluding the lacrimal drainage system, lacrimal gland and structures posterior
to the iris but including the treatment of iritis; (D) the examination of the human eye
for purposes of prescribing, fitting or insertion of contact lenses to the human eye. The
practice of optometry shall not include the use of surgery, x-ray, photocoagulation or
ionizing radiation, or the treatment of glaucoma. Nothing in this subdivision shall be
construed to limit the scope of practice of opticians licensed pursuant to chapter 381 or
the practice of physicians licensed pursuant to chapter 370.
(4) "Ocular agents-D" means: (A) Topically administered agents used for the purpose of diagnosing visual defects, abnormal conditions or the diseases of the human
eye and eyelid known generally as cycloplegics not to exceed one per cent, mydriatics
other than phenylephrine hydrochloride ten per cent and topical anesthetics, which are
administered topically for the examination of the human eye and the analysis of ocular
functions; (B) those vision training or optical devices which have been designated drugs
for preclearance testing by the federal Food and Drug Administration or similar agency;
and (C) fluorescein and similar dyes used in fitting contact lenses. The drugs described
in subparagraph (A) of this subdivision may be acquired and used only for diagnostic
purposes. Nothing in this subdivision shall be construed to allow an optometrist to acquire or use a controlled substance listed under section 21a-243.
(5) "Ocular agents-T" means: (A) Topically administered ophthalmic agents used
for the purpose of treating or alleviating the effects of diseases or abnormal conditions
of the human eye or eyelid excluding the lacrimal drainage system, lacrimal gland and
structures posterior to the iris, but including the treatment of iritis, excluding allergens,
alpha adrenergic agonists, antiparasitics, antifungal agents, antimetabolites, antineoplastics, beta adrenergic blocking agent, carbonic anhydrase inhibitors, collagen corneal
shields, epinephrine preparations, miotics used for the treatment of glaucoma, temporary
collagen implants and succus cineraria maritima; (B) orally administered antibiotics,
antihistamines and antiviral agents used for the purpose of treating or alleviating the
effects of diseases or abnormal conditions of the human eye or eyelid excluding the
lacrimal drainage system, lacrimal gland and structures posterior to the iris, but including
the treatment of iritis; and (C) orally administered analgesic agents used for the purpose
of alleviating pain caused by diseases or abnormal conditions of the human eye or eyelid
excluding the lacrimal drainage system, lacrimal gland and structures posterior to the
iris, but including the treatment of iritis. "Ocular agent-T" does not include any controlled substance or drug administered by injection.
(6) "Noninvasive procedures" means procedures used to diagnose or treat a disease
or abnormal condition of the human eye or eyelid excluding the lacrimal drainage system, lacrimal gland and structures posterior to the iris but including the removal of
superficial foreign bodies of the cornea and the treatment of iritis, provided the procedures do not require an incision or use of a laser.
(b) Optometrists who were first licensed prior to April 1, 1985, shall be permitted
to acquire and use ocular agents-D topically in the practice of optometry only after they
have completed a course which (1) consists of a minimum of forty-five classroom hours
and fifteen clinic hours, (2) is conducted by an institution accredited by a regional professional accreditation organization recognized or approved by the National Commission
on Accrediting or the United States Commissioner of Education and (3) is approved by
the Department of Public Health, and have passed an examination, prescribed by said
department with the advice and consent of the board of examiners in optometry, in
pharmacology as it applies to optometry, with a particular emphasis on the topical application of ocular agents-D to the eye for the purpose of examination of the human eye
and the analysis of ocular functions. Optometrists licensed on and after April 1, 1985,
shall not be required to take a course or pass an examination in order to acquire and use
said agents topically in the practice of optometry.
(c) Optometrists who were first licensed in this state prior to January 1, 1991, shall
be permitted to acquire, administer, dispense and prescribe ocular agents-T in the practice of optometry only after they have (1) successfully completed a minimum of ninety-six classroom hours and fourteen clinical hours in the didactic and clinical use of ocular
agents-T for the purposes of treating deficiencies, deformities, diseases or abnormalities
of the human eye, including the removal of foreign bodies from the eye and adnexae,
conducted by a duly accredited school or college of optometry or medical school, and
have passed an examination as administered by the accredited school or college of
optometry or medical school which conducted the course of study and (2) successfully
completed a course in cardiopulmonary resuscitation offered by an accredited hospital,
the American Heart Association or a comparable institution or organization. Proof of
successful completion of the courses required under subdivisions (1) and (2) of this
subsection shall be reported to the Department of Consumer Protection. Optometrists
licensed on and after January 1, 1991, and who have graduated from an accredited school
or college of optometry on or after January 1, 1991, shall not be required to take either
a course in the didactic and clinical use of ocular agents-T or a course in cardiopulmonary
resuscitation or pass an examination in order to acquire, administer, dispense and prescribe such ocular agents-T.
(d) Optometrists shall be permitted to engage in the practice of advanced optometric
care only after they have (1) successfully completed a minimum of seventy-five classroom hours and fifty-one clinical hours in the study of advanced optometric care that
includes the treatment of deficiencies, deformities, diseases or abnormalities of the human eye, including anterior segment disease, lacrimology and glaucoma conducted by
a duly accredited school or college of optometry or medical school, (2) passed an examination as administered by the accredited school or college of optometry or medical
school that conducted the course of study and (3) met the requirements that permit them
to acquire and use ocular agents-D and to acquire, administer, dispense and prescribe
ocular agents-T pursuant to subsections (b) and (c) of this section.
(e) No licensed optometrist authorized pursuant to this section to acquire, administer, dispense and prescribe an ocular agent-T shall dispense such agent to any person
unless no charge is imposed for such agent and the quantity dispensed does not exceed
a seventy-two-hour supply, except if the minimum available quantity for said agent is
greater than a seventy-two-hour supply, the optometrist may dispense the minimum
available quantity.
(f) No licensed optometrist authorized pursuant to this section to practice advanced
optometric care shall dispense controlled substances under schedules II, III, IV and V
or under section 21a-252, to any person unless no charge is imposed for such substances
and the quantity dispensed does not exceed a seventy-two-hour supply, except if the
minimum available quantity for said agent is greater than a seventy-two-hour supply,
the optometrist may dispense the minimum available quantity.
(g) (1) An optometrist may delegate to an optometric assistant, optometric technician or appropriately trained person the use or application of any ocular agent in accordance with section 20-138a, or an optometrist may cause the same to be self-administered
by a patient under the care and direction of the optometrist.
(2) No optometrist shall delegate to any person the authority to prescribe any ocular
agent.
(h) An optometrist shall refer any patient with iritis or a corneal ulcer to an ophthalmologist not later than seventy-two hours after commencement of initial treatment of
such condition unless there is improvement of such condition within such time period.
(i) Notwithstanding the provisions of section 52-184c, each optometrist authorized
by this section to practice advanced optometric care, or to use ocular agents-D or ocular
agents-T or both, shall be held to the same standard of care as ophthalmologists with
regard to such advanced optometric care, the use of such ocular agents-D or ocular
agents-T or both and any other procedures authorized by this section.
(j) Each optometrist authorized pursuant to this section to practice advanced optometric care, or to use ocular agents-D or ocular agents-T or both, shall post in a conspicuous location in each office waiting room, a standardized notice stating that said optometrist is authorized to practice advanced optometric care, or to use ocular agents for
diagnosis or treatment or both, within the scope of his practice.
(k) An optometrist engaged in the practice of advanced optometric care and the
nonsurgical treatment of glaucoma shall refer to an ophthalmologist or other physician,
for evaluation, any glaucoma patient who (1) presents with the presence of pediatric
glaucoma or closed angle glaucoma, or (2) does not improve in response to treatment.
Nothing in this subsection shall be construed to prohibit the emergency administration,
prior to referral, of medication otherwise authorized under this section.
(l) Each optometrist authorized pursuant to this section to practice advanced optometric care shall notify the Department of Public Health of his intent to engage in such
practice. The Commissioner of Public Health shall develop license renewal forms that
indicate whether a person holds himself out as authorized to practice advanced optometric care.
(m) On and after January 1, 2005, no initial license to engage in optometry shall be
issued unless the applicant meets the requirements of this section to practice advanced
optometric care. The foregoing provision shall not apply to optometrists licensed in this
state prior to January 1, 2005.
(1949 Rev., S. 4488; P.A. 73-343, S. 1, 2; P.A. 86-13, S. 2, 4; P.A. 87-129, S. 1; P.A. 92-88, S. 1; P.A. 93-381, S. 9,
39; P.A. 95-257, S. 12, 21, 58; P.A. 96-70, S. 1; June 30 Sp. Sess. P.A. 03-6, S. 146(d); P.A. 04-35, S. 1; 04-169, S. 17;
04-189, S. 1; P.A. 05-36, S. 1; P.A. 07-92, S. 1-4; 07-252, S. 79.)
History: P.A. 73-343 replaced definition of optometry as "employment of any means other than drugs for the measurement of the power of vision and the adaptation of lenses for the aid thereof" with detailed definition; P.A. 86-13 added
Subsec. (b) and amended Subsec. (a) to allow the use of diagnostic pharmaceutical agents for examination of the eye and
analysis of ocular functions; P.A. 87-129 substituted reference to Sec. 21a-243 for Sec. 21a-242, repealed by the same
act; P.A. 92-88 substantially revised the section including redefining optometrist and the practice of optometry, adding
definitions of ocular agents-D, ocular agents-T and noninvasive procedures, authorized use of ocular agents-T, provided
limits on use of ocular agents-T, added standard of care and included a posting requirement regarding use of ocular agents-T and ocular agents-D; P.A. 93-381 replaced department of health services with department of public health and addiction
services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction
Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 96-70 added the definition of
"practice of advanced optometric care", renumbering existing definitions, inserted new Subsec. (d) re requirements for
the practice of advanced optometric care, Subsec. (f) re controlled substances, Subsec. (k) re referral requirements and
Subsec. (l) re notification and license forms, relettering existing Subsecs. as necessary; June 30 Sp. Sess. P.A. 03-6 and
P.A. 04-169 replaced Department of Consumer Protection with Department of Agriculture and Consumer Protection,
effective July 1, 2004; P.A. 04-35 added Subsec. (m) re advanced optometric care requirements for initial license issued
after January 1, 2005; P.A. 04-189 repealed Sec. 146 of June 30 Sp. Sess. P.A. 03-6, thereby reversing the merger of the
Departments of Agriculture and Consumer Protection, effective June 1, 2004; P.A. 05-36 amended Subsec. (g) by designating existing provisions as Subdiv. (1) and amending same to allow optometrists to delegate certain duties re ocular agents,
and by adding Subdiv. (2) prohibiting the delegation of prescriptive authority for ocular agents; P.A. 07-92 amended
Subsec. (a)(1) to redefine "practice of advanced optometric care" to include removal of superficial foreign bodies of the
cornea, amended Subsec. (a)(6) to redefine "noninvasive procedures" to include removal of superficial foreign bodies of
the cornea, amended Subsec. (h) to delete requirement that optometrists refer patients with iritis or corneal ulcers who do
not show "documented substantial" improvement within 72 hours after commencement of initial treatment and amended
Subsec. (k) to delete referral requirements re patients who present with intraocular pressure over 35, patients with secondary
glaucoma and patients who do not have "documented substantial" improvement in response to treatment; P.A. 07-252
amended Subsec. (a)(6) to insert "the treatment of iritis".
Cited. 119 C. 673. See note to Sec. 20-133a.
Practice of optometry is a profession. 21 CS 332.