Can Texas therapeutic optometrists prescribe antiviral or glaucoma eye drugs, and could the optometry board list allowed drugs by category instead of by name?

Plain-English summary

In 1991, the Texas Legislature created a new kind of eye-care provider, the therapeutic optometrist, who, unlike a regular optometrist, can prescribe and give certain eye drugs. The law (Senate Bill 774) told the Texas Optometry Board to write a rule listing which drugs therapeutic optometrists may use. The board did, in a rule codified at 22 Texas Administrative Code section 280.5. The Texas State Board of Medical Examiners, the doctors' regulator, then asked the Attorney General to review the rule, raising both a constitutional question and two complaints about how the rule was written.

The constitutional question came first. Article III, section 51-a of the Texas Constitution deals with state aid and medical care for needy people. Its language says nothing in it permits optometrists to treat the eyes or to administer or prescribe drugs unless the optometrist is also a licensed physician. The medical examiners suggested that meant therapeutic optometrists could not constitutionally give drugs, at least to Medicaid patients. The Attorney General read the provision differently. Section 51-a does not, by itself, authorize optometrists to give drugs, and that is all the quoted language means. It does not prohibit drug authority; it simply leaves the question to the Legislature. Because the Legislature has now passed a statute allowing therapeutic optometrists to administer and prescribe ophthalmic devices, over-the-counter oral medications, and topical ocular agents, section 51-a does not stand in the way, including for Medicaid patients.

The first complaint about the rule was the one the Attorney General agreed with. The Optometry Act allows therapeutic optometrists to prescribe topical ocular agents "other than antiviral agents and antiglaucoma agents." The board's rule, however, listed drugs by category and let a therapeutic optometrist use a drug in a listed category so long as it was not being used to treat glaucoma in a newly prohibited way or as a banned antiviral. The medical examiners argued some of those drugs are antiviral or antiglaucoma agents, even if used for other eye conditions. The Attorney General concluded the statute's bar is absolute: section 1.03(b) unambiguously prohibits therapeutic optometrists from administering or prescribing antiviral and antiglaucoma topical ocular agents regardless of why they are being used. The legislative history backed this up, because the bill had been amended in committee specifically to limit prescription authority to agents "other than antiviral and antiglaucoma medications." So to the extent the rule let therapeutic optometrists use antiviral or antiglaucoma drugs even for a legitimate, unrelated purpose, it was an unreasonable reading of clear statutory language and was invalid.

The second complaint failed. The medical examiners argued that listing drugs by classification or category, instead of by brand or generic name, dodged the "specific" listing the statute required. The Attorney General disagreed. The statute did not define "specific," and in ordinary usage the word ranges from "falling into a specific category" to "definite or explicit." Given that ambiguity, and a board record explaining that naming every individual drug would run into the hundreds and change constantly, the board reasonably construed the act to permit a category-based list. So the rule was not invalid for failing to be specific enough.

Currency note

This opinion was issued in 1992. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here. The Texas Optometry Act (former V.T.C.S. article 4552) has since been recodified into the Occupations Code, and the board's rules, the Dangerous Drug Act provisions, and the scope of what therapeutic optometrists may prescribe (including glaucoma agents) have changed substantially since 1992, so confirm current law before relying on anything described here.

Background and statutory framework

During its regular session, the 72d Legislature passed Senate Bill 774, which amended the Texas Optometry Act to create an additional category of optometry practitioners, therapeutic optometrists. See Acts 1991, 72d Leg., ch. 588; V.T.C.S. art. 4552, §§ 1.02(2)(C), (7), 1.03, 3.01, 5.20. Both categories of practitioner, optometrists and therapeutic optometrists, employ objective or subjective means for ascertaining and measuring the powers of vision of the human eye, examining and diagnosing visual defects and diseases of the eye and adnexa, and fitting lenses or prisms to correct vision. Id. § 1.02(1); see id. § 1.02(7) (defining "practice of therapeutic optometry"). While the act prohibits optometrists from treating, prescribing, or administering any kind of drug, id. § 1.02(1), it authorizes therapeutic optometrists to administer or prescribe drugs or physical treatments as authorized by the act and to treat the eye and adnexa without the use of surgery or laser surgery, id. § 1.02(7); see id. § 1.03(b). In particular, a therapeutic optometrist may administer and prescribe ophthalmic devices, over-the-counter oral medications, and topical ocular pharmaceutical agents other than antiviral agents and antiglaucoma agents, for the purpose of diagnosing and treating visual defects, abnormal conditions, and diseases of the human eye and adnexa, but this does not authorize an optometrist to treat glaucoma in a manner not permitted by law on August 31, 1991. Id. § 1.03(b). Section 1.03(d) requires the Texas Optometry Board to adopt rules setting forth the specific pharmaceutical agents therapeutic optometrists may use, and section 1.03(e) creates a five-member technical advisory committee to assist the board in determining the specific agents. A therapeutic optometrist violates the act by using any pharmaceutical agent the board or any law does not authorize. Id. § 1.03(d).

In compliance with section 1.03(d), the board promulgated the rule codified at 22 Tex. Admin. Code § 280.5(g), (h) on December 18, 1991. In subsection (g), a therapeutic optometrist may prescribe all ophthalmic devices, over-the-counter oral medications, and topical pharmaceutical agents used for treating visual defects, abnormal conditions, and diseases of the human eye and adnexa, listed by classification or category rather than by generic or brand name. The rule states that a therapeutic optometrist may not use a listed drug to treat glaucoma in a manner not permitted by law on August 31, 1991, and excludes any antiviral drugs falling within the anti-infective classification. 22 T.A.C. § 280.5(g). Subject to those two restrictions, the rule permits a therapeutic optometrist to possess and administer any topical ocular pharmaceutical agent with a legitimate diagnostic or therapeutic use that falls within a listed category. Id. § 280.5(h).

On the constitutional question, the Attorney General considered whether article III, section 51-a of the Texas Constitution limits the authority created by sections 1.02(7) and 1.03. Generally, section 51-a excepts assistance grants and medical care for needy aged, disabled, and blind persons and needy dependent children from section 51's prohibition against legislative grants of public money to private individuals or associations. See Tex. Const. art. III, §§ 51, 51-a. The last paragraph of section 51-a provides that nothing in the section shall be construed to amend, modify, or repeal section 31 of article XVI; that medical care, services, or assistance shall include the employment of objective or subjective means, without the use of drugs, for ascertaining and measuring the powers of vision and fitting lenses or prisms; and that nothing in the section "shall be construed to permit optometrists to treat the eyes for any defect whatsoever in any manner nor to administer nor to prescribe any drug or physical treatment whatsoever, unless such optometrist is a regularly licensed physician or surgeon under the laws of this state." Tex. Const. art. III, § 51-a. The history of the 1964 amendment that added this paragraph indicates the legislature wanted to clarify that medical services authorized under section 51-a include fitting lenses to correct defective vision, and nothing in the first sentence limits its application to optometrists. The Attorney General construed the second sentence simply to affirm that section 51-a, in and of itself, does not authorize optometrists to administer or prescribe drugs or physical treatments to needy persons; it does not mean optometrists are constitutionally prohibited from doing so, but rather leaves the legislature discretion to authorize therapeutic optometrists to do so by statute. Because the legislature has now enacted such a statute, article III, section 51-a does not preclude therapeutic optometrists from administering and prescribing drugs to Medicaid patients.

On the first challenge to the rule, the Attorney General concluded that section 1.03(b) unambiguously and absolutely prohibits therapeutic optometrists from administering and prescribing antiviral and antiglaucoma topical ocular pharmaceutical agents, regardless of the use for which the agent is employed. The legislative history shows that Senate Bill 774 originally authorized therapeutic optometrists to prescribe all topical ocular medications but was amended in committee to limit that authority to topical ocular agents other than antiviral and antiglaucoma medications. See House Comm. on Public Health, Bill Analysis, S.B. 774, 72d Leg., R.S. (1991). Had the legislature intended to allow use of antiviral and antiglaucoma agents for purposes other than treating viral infections or glaucoma, it would have said so expressly. Although the rule prohibits using any listed drug to treat glaucoma in a manner not permitted by law on August 31, 1991, and prohibits antiviral drugs within the anti-infective classification, it does not otherwise limit the use of antiviral and antiglaucoma agents. 22 T.A.C. § 280.5(g)(3). Thus, to the extent the rule permits therapeutic optometrists to administer and prescribe drugs that are antiviral or antiglaucoma agents, even when used for a legitimate purpose unrelated to those properties, it is invalid. See Attorney General Opinion JM-1149 (1990) at 2 (courts will not respect an agency interpretation contrary to the clear meaning of an unambiguous statute).

On the second challenge, the Attorney General concluded the board reasonably listed permitted agents by classification or category. The act does not define "specific" in section 1.03(d), so the word takes its ordinary meaning, see Gov't Code § 312.002(a), and "specific" in common usage ranges from "constituting or falling into a specific category" to "definite or explicit." Compare WEBSTER'S NINTH NEW COLLEGIATE DICTIONARY 1132 (9th ed. 1990) with Steed v. State, 180 S.W.2d 446, 447 (Tex. Civ. App.-Texarkana), aff'd on other grounds, 183 S.W.2d 458 (Tex. 1944). Given the absence of evidence as to the intended meaning, the board could reasonably construe the statute to permit listing agents either by category or by name. The board's rulemaking record reflected its conclusion that requiring a listing of every agent by brand or generic name would run into the several hundreds and change regularly, so listing by category did not violate the legislative intent underlying section 1.03. The opinion therefore concluded section 280.5(g) is not invalid for failing to meet some statutorily required degree of specificity. See Attorney General Opinion JM-1149 at 2 (courts give weight to an agency's interpretation of an ambiguous statute).

Common questions

Can Texas therapeutic optometrists prescribe antiviral or glaucoma eye drugs?
Under this 1992 opinion, no. The Attorney General read section 1.03(b) of the Optometry Act as an absolute bar on administering or prescribing antiviral and antiglaucoma topical ocular agents, no matter the purpose, and held the board's rule invalid to the extent it allowed it. (The scope of what therapeutic optometrists may prescribe has changed by statute since then, so check current law.)

Did letting optometrists give drugs violate the Texas Constitution?
No. The opinion concluded article III, section 51-a does not itself authorize optometrists to give drugs, but it does not forbid it either; it leaves that choice to the Legislature, which authorized therapeutic optometrists to do so. So the statute and rule did not violate section 51-a, including as to Medicaid patients.

Could the board list allowed drugs by category instead of by name?
Yes. The opinion held that because the statute's requirement of a "specific" list was ambiguous, the board reasonably chose to list permitted agents by classification or category, especially since naming every drug would be unwieldy and constantly changing.

What is the difference between an optometrist and a therapeutic optometrist?
Both test and measure vision and fit corrective lenses. The opinion explained that an optometrist may not treat the eye with drugs, while a therapeutic optometrist may administer or prescribe certain drugs and non-surgical treatments as the act allows.

Citations

• V.T.C.S. arts. 4552-1.01 through 4552-5.20 (Texas Optometry Act); art. 4552, §§ 1.02(1), 1.02(2)(C), 1.02(7), 1.02(8), 1.03, 1.03(b), 1.03(d), 1.03(e), 3.01, 5.17, 5.20
• 22 Tex. Admin. Code § 280.5(g), (h), (g)(3)
• Tex. Const. art. III, §§ 51, 51-a; art. XVI, § 31
• Government Code § 312.002(a); Health & Safety Code § 483.001(3)
• Acts 1991, 72d Leg., ch. 588 (Senate Bill 774)
• Steed v. State, 180 S.W.2d 446 (Tex. Civ. App.-Texarkana), aff'd, 183 S.W.2d 458 (Tex. 1944)
• Attorney General Opinion JM-1149 (1990)

Source

• Landing page: https://www.texasattorneygeneral.gov/opinions/dan-morales/dm-0152
• Original PDF: https://www.texasattorneygeneral.gov/sites/default/files/opinion-files/opinion/1992/dm0152.pdf

Original opinion text

Best-effort transcription from a scanned PDF. Minor errors may remain, and several footnotes in the scan are heavily degraded; illegible citation numbers are marked rather than guessed. The linked PDF is authoritative.

Office of the Attorney General
State of Texas

DAN MORALES
ATTORNEY GENERAL

August 13, 1992

Mr. Homer R. Goehrs, M.D., F.A.C.P.
Executive Director
Texas State Board of Medical Examiners
P. O. Box 13562
Austin, Texas 78711-3562

Opinion No. DM-152

Re: Whether title 22 of the Texas Administrative Code section 280.5(g), (h) is consistent with section 1.03 of the Texas Optometry Act, V.T.C.S. arts. 4552-1.01 through 4552-5.20, and related questions (RQ-304)

Dear Dr. Goehrs:

On behalf of the Texas State Board of Medical Examiners, you have requested our opinion on whether Rule 280.5(g), (h) of the Texas Optometry Board is consistent with the intent of section 1.03 of the Texas Optometry Act (the act), V.T.C.S. article 4552-1.01 through article 4552-5.20. Tex. Optometry Bd., 16 Tex. Reg. 5812, adopted with amendment, 16 Tex. Reg. 7742 (1991). In addition, you ask how article III, section 51-a of the Texas Constitution affects the application of section 1.03 of the act.

During its regular session, the 72d Legislature passed Senate Bill 774, which amended the act to create an additional category of optometry practitioners: therapeutic optometrists. See Acts 1991, 72d Leg., ch. 588; V.T.C.S. art. 4552, §§ 1.02(2)(C), (7), 1.03, 3.01, 5.20. According to the amended act, both categories of optometry practitioners, optometrists and therapeutic optometrists, employ

         objective or subjective means . . . for the purpose of ascertaining and measuring the powers of vision of the human eye, examining and diagnosing visual defects, abnormal conditions, and diseases of the human eye and adnexa, and fitting lenses or prisms to correct or remedy any defect or abnormal condition of vision.

Id. § 1.02(1); see id. § 1.02(7) (defining "practice of therapeutic optometry"). However, while the act expressly prohibits optometrists from treating, prescribing, or administering any kind of drug (id. § 1.02(1)), the act expressly authorizes therapeutic optometrists to administer or prescribe drugs or physical treatments in the manner authorized by the act, and to treat the eye and adnexa[1] as authorized by the act without the use of surgery or laser surgery. Id. § 1.02(7); see id. § 1.03(b). In particular, the act authorizes therapeutic optometrists to, among other things, perform in the following manner:

           A therapeutic optometrist may administer and prescribe ophthalmic devices, over-the-counter oral medications, and topical ocular pharmaceutical agents[2] other than antiviral agents and antiglaucoma agents, for the purpose of diagnosing and treating visual defects, abnormal conditions, and diseases of the human eye and adnexa. . . . This subsection does not authorize an optometrist to treat glaucoma in a manner that was not permitted by law on August 31, 1991.[3]

Id. § 1.03(b) (footnotes added). Section 1.03(d) of the act requires the Texas Optometry Board (the board) to "adopt rules setting forth the specific pharmaceutical agents therapeutic optometrists may use in the practice of therapeutic optometry," and section 1.03(e) of the act creates a five-member technical advisory committee to assist the board in "determining the specific pharmaceutical agents" that therapeutic optometrists may use. (Emphases added.) A therapeutic optometrist violates the act if he or she uses any pharmaceutical agent that the board or any law does not authorize the therapeutic optometrist to use.[4] Id. § 1.03(d).

In compliance with section 1.03(d) of the act, the board promulgated the rule to be codified as title 22 of the Texas Administrative Code section 280.5(g), (h) on December 18, 1991.[5] In subsection (g), the board stated that a therapeutic optometrist may prescribe all ophthalmic devices, over-the-counter oral medications, and "topical pharmaceutical agents used for treating visual defects, abnormal conditions, and diseases of the human eye and adnexa." The rule then lists the permitted topical pharmaceutical agents by classification or category, not by generic or brand names.[6] Section 280.5 expressly states that a therapeutic optometrist may not use a drug falling within any of the listed categories to treat glaucoma in a manner that the law did not permit on August 31, 1991. 22 T.A.C. § 280.5(g); see supra note 3. The rule further expressly excludes any antiviral drugs falling within the category of anti-infective classification of pharmaceutical agents that a therapeutic optometrist permissibly may prescribe. 22 T.A.C. § 280.5(g). Subject to these two restrictions, however, the rule permits a therapeutic optometrist to "possess and administer any topical ocular pharmaceutical agent which has a legitimate diagnostic or therapeutic use" that falls within one of the listed categories. Id. § 280.5(h).

You question the validity of the rule on two grounds. First, you claim that the rule is inconsistent with section 1.03 of the act. Second, you appear to question whether sections 1.02(7) and 1.03 of the act, which authorize therapeutic optometrists to prescribe certain pharmaceutical agents, violate article III, section 51-a of the Texas Constitution. We consider your constitutional question first.

You request our opinion as to whether article III, section 51-a of the Texas Constitution "specifically limits optometrists from treating Medicaid patients only, or whether it is a broader prohibition." Generally, article III, section 51-a excepts assistance grants and medical care for needy aged, disabled and blind persons, and for needy dependent children from section 51's prohibition against legislative grants of public moneys to private individuals or associations. See Tex. Const. art. III, §§ 51, 51-a; 1 G. BRADEN, THE CONSTITUTION OF THE STATE OF TEXAS: AN ANNOTATED AND COMPARATIVE ANALYSIS at 236-46 (1977); R. WHITESIDE, THE IMPACT OF THE TEXAS CONSTITUTION ON PUBLIC WELFARE 17-21 (1973). However, the last paragraph of section 51-a states as follows:

           Nothing in this Section shall be construed to amend, modify or repeal Section 31 of Article XVI of this Constitution; provided further, however, that such medical care, services or assistance shall also include the employment of objective or subjective means, without the use of drugs, for the purpose of ascertaining and measuring the powers of vision of the human eye, and fitting lenses or prisms to correct or remedy any defect or abnormal condition of vision. Nothing herein shall be construed to permit optometrists to treat the eyes for any defect whatsoever in any manner nor to administer nor to prescribe any drug or physical treatment whatsoever, unless such optometrist is a regularly licensed physician or surgeon under the laws of this state.[7] [Emphases and footnote added.]

Tex. Const. art. III, § 51-a.

The history of the 1964 amendment to the constitution that added this paragraph indicates that the legislature, recognizing a great need previously unprovided among the state's senior citizens, wanted to clarify that medical services authorized under section 51-a include the fitting of lenses to correct or remedy defective vision. See Legislative Council, THREE CONSTITUTIONAL AMENDMENTS ANALYZED TO BE VOTED ON NOVEMBER 3, 1964, at 15. The first sentence of section 51-a's final paragraph therefore ensures that the medical services the state provides to needy persons includes proper vision testing and fitting for corrective lenses or prisms. We note that nothing in the sentence limits its application to optometrists.

We construe the language we have italicized in the second sentence of section 51-a's final paragraph simply to affirm that section 51-a, in and of itself, does not authorize optometrists to administer or prescribe drugs or physical treatments to needy persons receiving medical assistance. In our opinion, section 51-a's statement that "[n]othing herein shall be construed to permit optometrists to . . . administer nor to prescribe" drugs or physical treatments does not mean that optometrists constitutionally are prohibited from administering and prescribing drugs or physical treatments. Rather, section 51-a merely leaves the legislature with the discretion to authorize, by statute, therapeutic optometrists to administer and prescribe drugs or physical treatments. Because the legislature now has enacted a statute permitting therapeutic optometrists to administer and prescribe ophthalmic devices, over-the-counter oral medications, and topical ocular pharmaceutical agents, article III, section 51-a does not preclude therapeutic optometrists from administering and prescribing drugs to Medicaid patients.

Having resolved your constitutional question in the negative, we turn to your questions about the rule the board recently enacted, title 22 of the Texas Administrative Code section 280.5(g), (h), pursuant to the legislature's mandate in section 1.03(d) of the act. We understand you first to argue that, while article 4552-1.03(b) precludes therapeutic optometrists from administering and prescribing antiviral and antiglaucoma agents, the board has included in its list of pharmaceutical agents therapeutic optometrists may use some drugs that serve as antiviral and antiglaucoma agents, but that therapeutic optometrists legitimately may prescribe for other conditions of the eye as well. You state that the board rule "includes those [antiviral and antiglaucoma] agents under the premise that they would not be used for those conditions. This is an untenable position and is contrary to the specific language in" article 4552, section 1.03.

In our opinion, section 1.03(b) unambiguously and absolutely prohibits therapeutic optometrists from administering and prescribing antiviral and antiglaucoma topical ocular pharmaceutical agents, regardless of the use for which the therapeutic optometrist is legitimately using the agent. Indeed, the legislative history indicates that Senate Bill 774 originally authorized therapeutic optometrists to prescribe all topical ocular medications, but the bill was amended in committee to "[l]imit[] therapeutic optometrists' prescription authority to topical ocular agents other than antiviral and antiglaucoma medications." House Comm. on Public Health, Bill Analysis, S.B. 774, 72d Leg., R.S. (1991) (comparing original S.B. 774 to C.S.S.B. 774). Given this legislative history, we believe that the legislature, if it had intended to authorize therapeutic optometrists to use antiviral and antiglaucoma agents for purposes other than treating viral infections or glaucoma, would have said so expressly. We note that the rule expressly prohibits the use of any of the listed drugs for the treatment of glaucoma in a manner not permitted by law on August 31, 1991 (see supra note 3) and the use of any antiviral drugs that fall within the anti-infective classification, but the rule does not otherwise limit the use of antiviral and antiglaucoma agents. 22 T.A.C. § 280.5(g)(3). Thus, to the extent that the rule permits therapeutic optometrists to administer and prescribe drugs that are antiviral or antiglaucoma agents, even if the therapeutic optometrist is using the drug for a legitimate purpose unrelated to its antiviral or antiglaucoma properties, it is invalid.[8] See Attorney General Opinion JM-1149 (1990) at 2 (stating that courts will not respect agency interpretation contrary to clear meaning of unambiguous statute).

Next, you argue that subsection (g) of section 280.5, by listing pharmaceutical agents therapeutic optometrists may use by classification or category, attempts "to circumvent the specificity required by the language of" section 1.03. We disagree. We found no legislative history indicating what the legislature meant by its use of the word "specific" in section 1.03(d). Thus, we attach the ordinary meaning to the word. See Gov't Code § 312.002(a). However, "specific," as it is commonly used, has a range of definitions, from "constituting or falling into a specific category" to "definite or explicit." Compare WEBSTER'S NINTH NEW COLLEGIATE DICTIONARY 1132 (9th ed. 1990) with Steed v. State, 180 S.W.2d 446, 447 (Tex. Civ. App.-Texarkana), aff'd on other grounds, 183 S.W.2d 458 (Tex. 1944). Considering the absence of evidence as to the definition of "specific" the legislature intended, the board reasonably could construe the statute to authorize it to enact a rule listing permitted topical ocular pharmaceutical agents either by category or by generic or brand name.

We note that the board in its rulemaking process considered whether listing pharmaceutical agents by classification or category complied with statutory intent. See Texas Optometry Board, 16 Tex. Reg. 7742 (comment to rule 280.5). The board received several written comments on the issue. Ultimately, the board concluded that "[i]t would be unreasonable to require a listing of every pharmaceutical agent by brand or generic name, as the list would number into the several hundreds, and would change on a regular basis." Letter from Joe R. Greenhill, Jr., Counsel, Texas Optometry Bd. to C. J. Francisco, III, Texas Medical Assoc. (Dec. 18, 1991). In our opinion, the board reasonably concluded that listing by category the pharmaceutical agents therapeutic optometrists are permitted to use does not violate the legislative intent underlying section 1.03 of the act.[9] Thus, we conclude that section 280.5(g) of title 22 of the Texas Administrative Code is not invalid for failing to meet some statutorily required degree of specificity.[10] See Attorney General Opinion JM-1149 at 2 (stating that courts will give weight to agency's interpretation of ambiguous statute).

                             SUMMARY

          Neither V.T.C.S. article 4552-1.03 nor title 22 of the Texas Administrative Code section 280.5(g), (h) violates article III, section 51-a of the Texas Constitution. To the extent that title 22 of the Texas Administrative Code section 280.5(g), (h) permits therapeutic optometrists to administer and prescribe any antiviral or antiglaucoma drugs even if for legitimate purposes other than treating a virus or glaucoma, it represents an unreasonable construction of unambiguous language in V.T.C.S. article 4552-1.03, and, to that extent, it is invalid. However, the Board of Optometry reasonably construed section 1.03 to permit the board to list by classification or category, rather than by brand or generic name, those topical ocular pharmaceutical agents a therapeutic optometrist may administer and prescribe.

                                            DAN MORALES
                                            Attorney General of Texas

WILL PRYOR
First Assistant Attorney General

MARY KELLER
Deputy Assistant Attorney General

RENEA HICKS
Special Assistant Attorney General

MADELEINE B. JOHNSON
Chair, Opinion Committee

Prepared by Kymberly K. Oltrogge
Assistant Attorney General

[Footnote 1: "Adnexa" means the lids and drainage system of the eye. V.T.C.S. art. 4552-1.02(8).]

[Footnote 2: Scan illegible; the footnote appears to address topical ocular pharmaceutical agents but the text cannot be reliably transcribed.]

[Footnote 3: Prior to [August 31, 1991], optometrists who were under the control, supervision, or direction of a physician could treat glaucoma according to the physician's specific direction. See V.T.C.S. art. 4552-5.17. In our opinion, the enactment of section 1.03 does not prohibit an optometrist or therapeutic optometrist from continuing to treat glaucoma according to a physician's specified direction.]

[Footnote 4: We note that the [Texas] Dangerous Drug Act, Health & Safety Code [ch. 483], regulates the possession, delivery, and manufacture of all prescription drugs. See Health & Safety Code § 483.001(3). Senate Bill 774 amended the Dangerous Drug Act to add licensees of the Texas Optometry Board to the [practitioners] authorized to write prescriptions. Acts 1991, 72d Leg., ch. 588 [section number illegible in scan]; see Health & Safety Code [section number illegible]. In addition, Senate Bill 774 amended the Dangerous Drug Act to require pharmacists to determine that a therapeutic optometrist is authorized to prescribe a particular medication before dispensing the medication. Acts 1991, 72d Leg., ch. 588, § 27, at 2118; see Health & Safety Code [section number illegible]; infra note 10; see also V.T.C.S. art. 4542a-1, § 17 [subsection illegible in scan].]

[Footnote 5: The board adopted the rule on December 18, 1991.]

[Footnote 6: Scan illegible; the footnote concerns the listing of agents by classification or category.]

[Footnote 7: [Scan illegible.]]

[Footnote 8: [Scan illegible.]]

[Footnote 9: [Scan illegible.]]

[Footnote 10: [Scan illegible.]]