Connecticut bills regulate plano lenses, delegate eye drops

Issue: September 2005

ByJennifer Byrne

Two pieces of legislation recently passed in Connecticut promise to improve patient care — one through the regulation of plano contact lens sales and the other through the legal delegation of eye drops by optometrists and ophthalmologists.

This coincided with S. 172, a bill recently passed in the U.S. Senate. Pending passage of the companion bill in the House of Representatives, this legislation would categorize all contact lenses as medical devices and stipulate that a prescription must accompany the purchase of all plano lenses.

“This is legislation that just makes sense,” said Donald Higgins, OD, president-elect of the Connecticut Association of Optometry (CAO), of the Connecticut bills. “I don’t think we encountered very much opposition to either bill.”

HB 6302: responsible retail

House Bill 6302, now Public Act 05-119, passed both the Connecticut House and the Senate without opposition and goes into effect Oct. 1. This legislation restricts the sale of plano (non-prescription) contact lenses to retail settings that are supervised by a licensed optician or in a registered optical establishment, office or store.

“These lenses were being sold everywhere from tattoo parlors on down, and we thought the public was at risk,” Dr. Higgins told Primary Care Optometry News. “They were being treated as a non-medical device with absolutely no regulation. We knew we needed to do something that would regulate this type of activity.”

The language of the legislation specifically stipulates that optometrists and ophthalmologists are not restricted from selling plano lenses. “The supervision of an optician is required under the law, but that obviously doesn’t preclude them being sold under an optometrist or an ophthalmologist,” Dr. Higgins said. “However, there must at least be a licensed optician and a registered optical establishment.”

Because the bill straightforwardly promoted patient safety, there was very little resistance to it, Dr. Higgins said. “Anything you put into or onto your body like that is a medical device and should not be treated cavalierly,” he said. “It’s legislation that just made sense.”

S. 172 protects consumer safety

On July 29, the U.S. Senate passed S. 172, a bill designed to classify plano lenses as medical devices and prevent the selling of such lenses without a prescription. The companion bill, H.R. 371, must now be passed in the House of Representatives, according to a press release from Prevent Blindness America (PBA).

Until 2 years ago, plano contact lenses were classified as Class II or Class III medical devices by the U.S. Food and Drug Administration. In April 2003, however, the FDA redefined plano lenses as cosmetic devices.

According to PBA, the passage of this legislation in the Senate was largely the result of a grassroots effort by the group, which enlisted the help of volunteers and affiliates across the country in support of the bill.

“We are thrilled to see our powerful grassroots movement of patients and consumers across the country make an impact on such an important issue,” said Daniel D. Garrett, senior vice president of PBA, in a press release. “Thanks to the combined efforts of professional organizations and volunteer groups like ours, we were able to take another step closer to protecting the eyes of all Americans.”

HB 6820: improving patient flow

Signed into law on May 17 by Connecticut Gov. M. Jodi Rell, HB 6820 will allow greater freedom for both optometry and ophthalmology. The bill, which is now Public Act 05-36, allows for the “delegation to trained people the use and application of ocular agents.”

Dr. Higgins said that previously it was illegal for either optometrists or ophthalmologists to delegate the dispensing of eye drops to technicians or other staff. “In other words, although it was widely done, it was against the law,” he said. “Our law specifically stated that we could not delegate the dispensing of eye drops, be it cycloplegics, anesthetics or mydriatic drugs to anyone.”

Dr. Higgins said this caused a dilemma for practitioners: although allowing technicians to administer eye drops saves time and keeps the office running smoothly and efficiently, it was illegal. “I believe a lot of practitioners were still having a patient come in and having the technician put in the drops before the doctor got there,” he said. “But in doing that, practitioners were breaking the law.”

Because ophthalmologists were restricted by the previous law in the same way that optometrists were, they raised very little opposition and eventually were in favor of the proposed bill, Dr. Higgins said. “When we pointed out to them that they were held to the same standards as we were, they took a second look,” he said. “So we got together with ophthalmology and decided that it would be in the best interest of both groups to delegate the administration of eye drops.”

Dr. Higgins said this practice is safe for patients and will greatly improve office flow. “Before, if a patient needed to be dilated, the initial contact had to be made by me. I had to bring patients to the exam chair and dilate them,” he said. “With the passage of this bill, once the patient is there, that patient can be administered eye drops, so he or she is not waiting for me. It promotes patient flow and patient care.”

For Your Information:

Donald Higgins, OD, is president-elect of the Connecticut Optometric Association. He can be reached at 74 Main St., Plainville, CT 06062-1938; (860) 793-9613; fax: (860) 747-6880; e-mail: hbvc@aol.com.

Daniel D. Garrett is senior vice president of Prevent Blindness America. He can be reached at 211 West Wacker Dr., Suite 1700, Chicago, IL 60606; (312) 363-6035.