This article is more than 5 years old. Information may no longer be current.
Connecticut legislature expands TPA use
Click Here to Manage Email Alerts
HARTFORD, Conn.—Although it received a tailoring that eliminated the opportunity for ODs to use therapeutic lasers, a bill that significantly expands therapeutic pharmaceutical agent (TPA) privileges has passed the Connecticut legislature here.
On April 23, an amended form of Senate Bill 353 passed the House 137-11, and then passed the Senate. At press time, the bill had moved on to Gov. John Rowland (R).
On March 20, the Senate passed the original version of the bill, which included provisions that allowed ODs to use lasers therapeutically. That caused a furor among ophthalmologists as it granted optometrists the privilege to perform procedures such as photorefractive keratectomy. However, the bill was whittled down by Anne McDonald (D), House Chair on the Public Health Committee, who eliminated lasers and optometric treatment of ocular cancer.
The final product appears to have struck a classic compromise: neither optometry nor ophthalmology is overly happy with the results. "Both sides didn't like it," said Robert Palozej, OD, legislative chair of the Connecticut Association of Optometrists.
The bill still significantly expands the scope of optometric practice. "It is still very strong," Palozej said. "It allows the use of any pharmaceutical agent, including controlled substances, for the purposes of diagnosing and treating the eye and ocular adnexa."
Diagnostic lasers included
ODs can treat glaucoma—although oral drugs only for emergencies—and use diagnostic lasers. Previously, optometrists in the state could not treat glaucoma, prescribe oral drugs for inflammation or give controlled substances to treat pain. The original bill was passed in 1992.
The Connecticut Society of Eye Physicians (CSEP) was relieved that the bill prohibits ODs from performing surgery, but Jacquelyn Coleman, CSEP executive director, said they are still not overjoyed at the resulting legislation.
"We recognize that this bill is better for the citizens of Connecticut than the previous bill was," Coleman said. "But we philosophically still don't agree that optometrists should be allowed to treat glaucoma or use controlled substances."
Palozej said the bill also defined surgery more clearly, "opening the door for optometrists to perform noninvasive surgical procedures," such as removing a foreign body, epilating an eyelash or dilating and irrigating the puncta. "Those things use surgical codes and we had problems in the past billing them," Palozej said. "To us, noninvasive means it doesn't require an incision. This opens up a lot of procedures to us."
ODs pursuing technology
Although Connecticut's effort fell short, the drive to use therapeutic lasers seems to be part of a national climate where optometrists are seeking laser and other privileges. "Optometrists are frustrated by some of the new technology we feel is within our purview and our education, and we can't get access to it," Palozej said. In Connecticut, he said, "We just did what we thought was right and what we thought the trend was in the country. We've always been late—47th in diagnostics, 31st in therapeutics—and we didn't want to be late on this one, that's all."