1     
OPTOMETRIST PRACTICE AMENDMENTS

2     
2024 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Curtis S. Bramble

5     
House Sponsor: James A. Dunnigan

6     

7     LONG TITLE
8     General Description:
9          This bill allows an optometrist to perform certain laser procedures.
10     Highlighted Provisions:
11          This bill:
12          ▸     creates a certification for an optometrist to perform certain laser procedures;
13          ▸     requires an optometrist to obtain training to obtain the certification;
14          ▸     requires a certified optometrist to comply with reporting requirements and other
15     standards;
16          ▸     requires the Office of Professional Licensure Review to make a recommendation
17     after reviewing outcome data on whether optometrists should continue performing
18     the laser procedures; and
19          ▸     creates a sunset date.
20     Money Appropriated in this Bill:
21          None
22     Other Special Clauses:
23          None
24     Utah Code Sections Affected:
25     AMENDS:
26          58-16a-102, as last amended by Laws of Utah 2020, Chapter 339
27          58-16a-501, as last amended by Laws of Utah 2020, Chapter 339

28          58-16a-502, as last amended by Laws of Utah 2020, Chapter 25
29          58-16a-601, as last amended by Laws of Utah 2017, Chapter 292
30          63I-1-258, as last amended by Laws of Utah 2023, Chapter 303
31     ENACTS:
32          58-16a-602, Utah Code Annotated 1953
33     

34     Be it enacted by the Legislature of the state of Utah:
35          Section 1. Section 58-16a-102 is amended to read:
36          58-16a-102. Definitions.
37          In addition to the definitions in Section 58-1-102, as used in this chapter:
38          (1) "Board" means the Optometrist Licensing Board created in Section 58-16a-201.
39          (2) "Contact lens" means any lens that:
40          (a) has a spherical, cylindrical, or prismatic power or curvature;
41          (b) is made pursuant to a current prescription; and
42          (c) is intended to be worn on the surface of the eye.
43          (3) (a) "Contact lens prescription" means a written or verbal order for contact lenses
44     that includes:
45          (i) the commencement date of the prescription;
46          (ii) the base curve, power, diameter, material or brand name, and expiration date;
47          (iii) for a written order, the signature of the prescribing optometrist or physician; and
48          (iv) for a verbal order, a record maintained by the recipient of:
49          (A) the name of the prescribing optometrist or physician; and
50          (B) the date when the prescription was issued or ordered.
51          (b) A prescription may include:
52          (i) a limit on the quantity of lenses that may be ordered under the prescription if
53     required for medical reasons documented in the patient's files; and
54          (ii) the expiration date of the prescription, which shall be two years from the
55     commencement date, unless documented medical reasons require otherwise.
56          (c) When a provider prescribes a private label contact lens for a patient the prescription
57     shall include:
58          (i) the name of the manufacturer;

59          (ii) the trade name of the private label brand; and
60          (iii) if applicable, the trade name of the equivalent national brand.
61          (4) "Contact lens prescription verification" means a written request from a person who
62     sells or provides contact lenses that:
63          (a) is sent to the prescribing optometrist or physician; and
64          (b) seeks the confirmation of the accuracy of a patient's prescription.
65          (5) "Eye and its adnexa" means the human eye and all structures situated within the
66     orbit, including the conjunctiva, lids, lashes, and lacrimal system.
67          (6) "Fitting of a contact lens" means:
68          (a) the using of a keratometer to measure the human eye;
69          (b) utilizing refractive data provided by a licensed optometrist or ophthalmologist; and
70          (c) trial fitting of contact lenses, which includes a period of time for evaluation for fit
71     and performance, to determine a tentative contact lens prescription for a patient if the patient:
72          (i) has not worn contact lenses before; or
73          (ii) has changed to a different type or base curve.
74          (7) "Laser surgery" means surgery in which human tissue is cut, burned, or vaporized
75     by means of laser or ionizing radiation.
76          (8) "Ophthalmic lens" means any lens used to treat the eye and that:
77          (a) has a spherical, cylindrical, or prismatic power;
78          (b) is made pursuant to an unexpired prescription; and
79          (c) is intended to be used in eyeglasses or spectacles.
80          (9) "Optometric assistant" means an unlicensed individual:
81          (a) working under the direct and immediate supervision of a licensed optometrist; and
82          (b) engaged in specific tasks assigned by the licensed optometrist in accordance with
83     the standards and ethics of the profession.
84          (10) "Optometrist" or "optometric physician" means an individual licensed under this
85     chapter.
86          (11) "Optometry" and "practice of optometry" mean any one or any combination of the
87     following practices:
88          (a) examination of the human eye and its adnexa to detect and diagnose defects or
89     abnormal conditions;

90          (b) determination or modification of the accommodative or refractive state of the
91     human eye or its range or power of vision by administration and prescription of pharmaceutical
92     agents or the use of diagnostic instruments;
93          (c) prescription, ordering, administration, or adaptation of ophthalmic lenses, contact
94     lenses, ophthalmic devices, pharmaceutical agents, laboratory tests, or ocular exercises to
95     diagnose and treat diseases, defects, or other abnormal conditions of the human eye and its
96     adnexa;
97          (d) display of any advertisement, circular, sign, or device offering to:
98          (i) examine the eyes;
99          (ii) fit glasses or contact lenses; or
100          (iii) adjust frames;
101          (e) removal of a foreign body from the eye or its adnexa, that is not deeper than the
102     anterior 1/2 of the cornea; [and]
103          (f) consultation regarding the eye and its adnexa with other appropriate health care
104     providers, including referral to other appropriate health care providers[.]; and
105          (g) performing a procedure that is described in Section 58-16a-602.
106          (12) "Pharmaceutical agent" means any diagnostic or therapeutic drug or combination
107     of drugs that has the property of assisting in the diagnosis, prevention, treatment, or mitigation
108     of abnormal conditions or symptoms of the eye and its adnexa.
109          (13) "Physician" has the same meaning as defined in Sections 58-67-102 and
110     58-68-102.
111          (14) "Prescription drug" has the same definition as in Section 58-17b-102.
112          (15) "Unexpired" means a prescription that was issued:
113          (a) for ophthalmic lenses which does not expire unless the optometrist or physician
114     includes an expiration date on the prescription based on medical reasons that are documented
115     in the patient's file; and
116          (b) in accordance with Subsection (3) for a contact lens.
117          Section 2. Section 58-16a-501 is amended to read:
118          58-16a-501. Unlawful conduct.
119          "Unlawful conduct" includes, in addition to the definition in Section 58-1-501:
120          (1) buying, selling, or fraudulently obtaining, any optometry diploma, license,

121     certificate, or registration;
122          (2) selling or providing contact lenses or ophthalmic lenses in a manner inconsistent
123     with Section 58-16a-801 or intentionally altering a prescription unless the person selling or
124     providing the lenses is a licensed optometrist or ophthalmologist; [or]
125          (3) representing oneself as or using the title of "optometrist," "optometric physician,"
126     "doctor of optometry," or "O.D.," unless currently licensed under this chapter[.]; or
127          (4) performing a procedure described in Section 58-16a-602 without obtaining the
128     certification described in Section 58-16a-602.
129          Section 3. Section 58-16a-502 is amended to read:
130          58-16a-502. Unprofessional conduct.
131          "Unprofessional conduct" includes, in addition to the definition in Section 58-1-501:
132          (1) using or employing the services of an optometric assistant to assist a licensee in any
133     manner not in accordance with:
134          (a) the generally recognized practices and standards of ethics of the profession; or
135          (b) applicable state law or division rule;
136          (2) failure to refer a patient to an appropriate licensed practitioner when:
137          (a) the patient's condition does not respond to treatment; or
138          (b) the treatment is not within the scope of competence or licensure of the licensee;
139          (3) providing confidential information regarding a patient to any third party who does
140     not have a legal and professional ground for obtaining the information;
141          (4) knowingly prescribing, selling, giving away, or administering any prescription drug
142     unless:
143          (a) for a legitimate medical purpose;
144          (b) upon a proper diagnosis indicating the use of the drug in the amount prescribed or
145     provided; and
146          (c) in compliance with Section 58-17b-309;
147          (5) giving or receiving directly or indirectly any fee, commission, rebate, or other
148     compensation for professional services not actually and personally rendered, except as part of a
149     legal relationship within a lawful professional partnership, corporation, or association;
150          (6) failure to transfer pertinent and necessary information from a patient's medical
151     records to another optometrist or physician when so requested by the patient or his

152     representative, as designated in writing;
153          (7) failure to provide a contact lens prescription to a person who sells contact lenses in
154     accordance with Section 58-16a-306; [or]
155          (8) falsely making an entry in, or altering, a medical record with the intent to conceal:
156          (a) a wrongful or negligent act or omission of an individual licensed under this chapter
157     or an individual under the direction or control of an individual licensed under this chapter; or
158          (b) conduct described in Subsections (1) through (7) or Subsection 58-1-501(1)[.]; or
159          (9) falsely reporting data required under Section 58-16a-602.
160          Section 4. Section 58-16a-601 is amended to read:
161          58-16a-601. Scope of practice.
162          (1) An optometrist may:
163          (a) provide optometric services not specifically prohibited under this chapter or
164     division rules if the services are within the optometrist's training, skills, and scope of
165     competence; and
166          (b) prescribe or administer pharmaceutical agents for the eye and its adnexa, including
167     oral agents, subject to the following conditions:
168          (i) an optometrist may prescribe oral antibiotics for only eyelid related ocular
169     conditions or diseases, and other ocular conditions or diseases specified by division rule; and
170          (ii) an optometrist may administer or prescribe a hydrocodone combination drug, or a
171     Schedule III controlled substance, as defined in Section 58-37-4, only if:
172          (A) the substance is administered or prescribed for pain of the eye or adnexa;
173          (B) the substance is administered orally or topically or is prescribed for oral or topical
174     use;
175          (C) the amount of the substance administered or prescribed does not exceed a 72-hour
176     quantity; and
177          (D) if the substance is prescribed, the prescription does not include refills.
178          (2) An optometrist may not:
179          (a) except as provided in Section 58-16a-602, perform surgery, including laser surgery;
180     or
181          (b) prescribe or administer a Schedule II controlled substance, as defined in Section
182     58-37-4, except for a hydrocodone combination drug, if so scheduled and prescribed or

183     administered in accordance with Subsection (1)(b).
184          (3) For purposes of Sections 31A-22-618 and 31A-45-303, an optometrist is a health
185     care provider.
186          Section 5. Section 58-16a-602 is enacted to read:
187          58-16a-602. Certification for certain laser procedures.
188          (1) As used in this section:
189          (a) "Certified optometrist" means an optometrist who has obtained a certification under
190     this section.
191          (b) "Selective laser trabeculoplasty" means using a laser to treat glaucoma by targeting
192     the trabecular meshwork.
193          (c) "YAG laser capsulotomy" means using a neodymium-doped yttrium aluminum
194     garnet laser to treat opacification of the lens capsule after cataract surgery or lens replacement
195     surgery.
196          (2) To obtain a certification to perform YAG laser capsulotomy or a certification to
197     perform selective laser trabecloplasty, an optometrist shall provide proof of:
198          (a) completing 32 hours of coursework on laser procedures from an accredited college
199     or school of optometry that contains a written competency exam and a clinical competency
200     exam;
201          (b) for the procedure in which certification is requested, performing at least five
202     procedures under the direct supervision of a certified optometrist or an ophthalmologist; and
203          (c) establishing a relationship with an ophthalmologist.
204          (3) A certified optometrist shall:
205          (a) submit to the division all patient outcome data requested by the division under this
206     section;
207          (b) meet continuing education requirements;
208          (c) disclose procedure risk to any patient undergoing a procedure;
209          (d) provide to the patient:
210          (i) a form with information regarding when to seek treatment from an ophthalmologist;
211     and
212          (ii) a form detailing how to file a complaint with the division regarding procedures
213     provided by the certified optometrist;

214          (e) if required by the ophthalmologist described in Subsection (2)(c), notify the
215     ophthalmologist:
216          (i) regarding when a procedure will take place; and
217          (ii) of any complications that arise when performing a procedure; and
218          (f) obtain any necessary disclosures from a patient to be able to comply with the data
219     reporting requirements of this section.
220          (4) The division may:
221          (a) refuse to certify an optometrist under this section if the optometrist has a history of
222     complaints or negligence;
223          (b) require additional information from an optometrist described in Subsection (4)(a)
224     before issuing a certification; or
225          (c) revoke a certification for failing to comply with Subsection (3).
226          (5) The division shall:
227          (a) establish continuing education requirements for a certified optometrist regarding
228     YAG laser capsulotomy and selective laser trabecloplasty;
229          (b) provide data collected under this section to the Office of Professional Licensure
230     Review in accordance with Subsection (7); and
231          (c) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
232     make rules:
233          (i) to implement this section; and
234          (ii) in consultation with the Office of Professional Licensure Review, to determine the
235     data necessary for the report described in Subsection (7).
236          (6) (a) A certification expires on the date an optometrist's license under this chapter
237     expires.
238          (b) The division shall renew a certification if the optometrist has complied with
239     Subsection (3) and any associated rules created under this section.
240          (7) The Office of Professional Licensure Review shall obtain data collected by the
241     division to issue a written report before May 1, 2028, regarding:
242          (a) whether the practice of optometry should include conducting YAG laser
243     capsulotomy or selective laser trabecloplasty;
244          (b) whether certification is necessary; and

245          (c) if certification is necessary, improvements or modifications to the certification
246     process or requirements.
247          Section 6. Section 63I-1-258 is amended to read:
248          63I-1-258. Repeal dates: Title 58.
249          (1) Section 58-3a-201, which creates the Architects Licensing Board, is repealed July
250     1, 2026.
251          (2) Title 58, Chapter 13, Health Care Providers Immunity from Liability Act, is
252     repealed July 1, 2026.
253          (3) Title 58, Chapter 15, Health Facility Administrator Act, is repealed July 1, 2025.
254          (4) Section 58-16a-602, related to laser procedures, is repealed July 1, 2029.
255          [(4)] (5) Title 58, Chapter 20b, Environmental Health Scientist Act, is repealed July 1,
256     2028.
257          [(5)] (6) Subsection 58-37-6(7)(f)(iii), relating to the seven-day opiate supply
258     restriction, is repealed July 1, 2032, and the Office of Legislative Research and General
259     Counsel is authorized to renumber the remaining subsections accordingly.
260          [(6)] (7) Title 58, Chapter 40, Recreational Therapy Practice Act, is repealed July 1,
261     2033.
262          [(7)] (8) Title 58, Chapter 41, Speech-Language Pathology and Audiology Licensing
263     Act, is repealed July 1, 2029.
264          [(8)] (9) Title 58, Chapter 42a, Occupational Therapy Practice Act, is repealed July 1,
265     2025.
266          [(9)] (10) Title 58, Chapter 46a, Hearing Instrument Specialist Licensing Act, is
267     repealed July 1, 2033.
268          [(10)] (11) Title 58, Chapter 47b, Massage Therapy Practice Act, is repealed July 1,
269     2024.
270          [(11)] (12) Subsection 58-55-201(2), which creates the Alarm System and Security
271     Licensing Advisory Board, is repealed July 1, 2027.
272          [(12)] (13) Subsection 58-60-405(3), regarding certain educational qualifications for
273     licensure and reporting, is repealed July 1, 2032.
274          [(13)] (14) Title 58, Chapter 61, Part 7, Behavior Analyst Licensing Act, is repealed
275     July 1, 2026.

276          [(14)] (15) Title 58, Chapter 72, Acupuncture Licensing Act, is repealed July 1, 2027.
277          Section 7. Effective date.
278          This bill takes effect on May 1, 2024.