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Issue: July 2009
ByStephanie R. Vasta
July 01, 2009
2 min read
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Maine optometrists pass law to remove restrictions on prescribing

Issue: July 2009
ByStephanie R. Vasta

The Maine State Legislature unanimously passed LD-683, now called 2009 Public Law 195, which removed many restrictions from the state law of Maine for optometrists.

This law will simplify the multiple levels of licensure in Maine and allow optometrists to prescribe oral medications without quantity restrictions, dispense therapeutic contact lenses and independently treat glaucoma.

Necessary for access

The 2009 Public Law 195 was inspired by outdated laws that needed to be amended to reflect changes in optometric practice and technology, according to Linda Cameron, OD, president of the Maine Optometric Association.

“In a state like Maine, which is quite geographically diverse, optometrists are the primary care eye providers and see the majority of patients across the state on a more routine basis,” Dr. Cameron said in an interview with Primary Care Optometry News. “Ophthalmologists do not have as much presence in rural areas, so it’s important that Maine optometrists are able to provide care at an advanced level to ensure the people of Maine have access to high quality and efficient eye care.”

Prescribing oral medications

One restriction lifted from Maine’s state law through 2009 Public Law 195 concerns optometrists’ ability to prescribe oral medications. Going forward, optometrists are able to prescribe any oral medication for an ocular disease or condition for any length of time.

“It used to be that optometrists were allowed to use topical therapeutic pharmaceutical agents, but only limited types of oral medications,” Dr. Cameron said. “There were also limitations on the quantities that could be prescribed.”

There are, of course, exceptions, which were agreed upon between optometry and ophthalmology before presenting the bill to legislators.

“We cannot prescribe oral chemotherapeutic agents, oral immunosuppressant agents or oral immunostimulant agents,” Dr. Cameron said. “And there still is a restriction that we may prescribe no more than a 5-day supply of any Schedule III analgesic-type medication, for example Vicodin (acetaminophen and hydrocodone, Abbott), for a patient in extreme pain caused by an eye injury.”

Dispensing therapeutic contact lenses

In an attempt to remain current as technology changes, the law will also allow optometrists to dispense and prescribe therapeutic contact lenses once the technology is approved for sale by the U.S. Food and Drug Administration.

According to Dr. Cameron, amending state law was necessary for not only Maine, but several other states as well.

While optometrists have been able to separately prescribe contact lenses and medication, “to have them combined in a product was considered a different entity,” Dr. Cameron said. “So a lot of states, by their own laws, were not allowed to prescribe, dispense or sell them. Our new law will allow us to do all those things.”

Independent glaucoma treatment

One of the most significant changes made to the state law of Maine concerns optometrists’ ability to independently treat glaucoma. In 1995, Maine amended state law to allow an optometrist to earn an advanced therapeutic license with glaucoma authority by comanaging 50 patients with an ophthalmologist. Upon completion, the optometrist was permitted to independently treat glaucoma with this advanced license.

By passing 2009 Public Law 195, Maine reduced the number of comanaged cases to 30 and declared that optometrists who graduated after 1995 automatically qualify for the advanced therapeutic license with glaucoma authority.

“Now there is a clause to be able to appeal for a reduction or waiver of the comanagement cases through the glaucoma subcommittee if optometrists can show evidence that they are qualified or a waiver if they had glaucoma privileges in another state,” Dr. Cameron added.

By amending state law, Dr. Cameron expects 2009 Public Law 195 will reduce the multiple levels of licensure in Maine and allow optometrists to practice to their highest level of training and expertise to care for Maine’s citizens.

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