Texas Scope of Practice
Texas is the second-largest state in the US and spans over 268,000 square miles- roughly the size of the country of Spain! Texas may be known for rodeos, 10-gallon hats, and cowboy boots, but those who call it home can attest to the cultural vibrance and history. Big cities in Texas include Houston, Austin, Dallas/Ft. Worth, San Antonio, El Paso, Arlington, and Corpus Christi, and each city and area of the state has its own unique flair.
Whether it’s biking along the beach in Galveston or checking out the nightlife in Austin, the Texas lifestyle has a little something for everyone. Texas is home to over 170 colleges and universities including Texas A&M, University of Texas, Texas Tech, and Baylor. Additionally, there are two optometry schools associated with Texan universities: University of Houston and The University of the Incarnate Word.
Because of its large area and population, Texas has a major shortage of healthcare physicians. In fact, many institutions like The University of Houston are taking on the public health crisis by opening up medical schools specifically geared to generate more primary care doctors like gerontologists, gynecologists, family medical doctors, and pediatricians.
For optometrists in Texas, scope of practice may be generous, but it still falls short of the current skill sets taught at colleges of optometry. In fact, Texan optometric law states,
“Only an optometric glaucoma specialist licensed by the Board may prescribe oral medications. Oral medications may only be prescribed in the following classifications and only to treat medical conditions within the scope of practice of an optometric glaucoma specialist:
• one 10‑day supply of oral antibiotics
• one 72‑hour supply of oral antihistamines
• one seven‑day supply of oral nonsteroidal anti‑inflammatories
• one three‑day supply of any analgesic identified in Schedules III, IV, and V of 21
U.S.C. Section 812”
Luckily, the Texas Optometric Association (TOA) is an active state organization that helps defend the rights of optometric physicians in the Lone Star state while also pushing for scope expansion.
Texas optometrists CAN:
- Prescribe oral medications such as antibiotics, steroids, antifungals, and schedule III, IV, and V controlled substances.
- Diagnose and treat glaucoma with topical drugs but only after consulting an ophthalmologist within 30 days of initial diagnosis
- Co-manage post-op care
- Perform procedures such as foreign body removal, dilation and irrigation, punctal occlusion, and eyelash epilation
- Dispense spectacles and contact lenses
- Provide and aid in care of ocular prosthetics
- Order laboratory tests required for the examination, diagnosis, and treatment of a disease or condition related to the human eye
Texas optometrists CANNOT:
- Prescribe oral steroids
- Treat glaucoma without initially consulting an ophthalmologist
- Prescribe oral glaucoma agents
- Perform minor surgical procedures to correct ocular abnormalities, such as removal of “lumps and bumps” around the eye
- Perform anterior segment laser procedures including YAG capsulotomy used to treat cloudy lens implants following cataract surgery, Selective Laser Trabeculoplasty (SLT), and Laser Peripheral Iridotomy (LPI) used to treat some forms of glaucoma
- Administer medications, including anesthetics, by injection, including subcutaneous infiltrative, intralesional, intramuscular, intravenous, and subconjunctival routes
- Perform anterior segment laser procedures including YAG capsulotomy used to treat cloudy lens implants following cataract surgery, Selective Laser Trabeculoplasty (SLT), or Laser Peripheral Iridotomy (LPI) used to treat some forms of glaucoma
- Laser or non-laser injection into the posterior chamber of the eye to treat any macular or retinal disease
As a legislated profession, optometry is dependent on the civic engagement of optometrists and optometry students alike. For more articles about the optometric scope of practice in other states, click here!