Optometry: assistants and scope of practice.

Existing law prohibits any person, other than a physician and surgeon or optometrist, from measuring the powers or range of human vision or determining the accommodative and refractive status of the human eye or the scope of its functions in general or prescribing ophthalmic devices. Existing law provides that an assistant in any setting where optometry or ophthalmology is practiced who is acting under the direct responsibility and supervision of an ophthalmologist or optometrist may, among other things, perform tonometry and perform nonsubjective auto refraction in connection with subjective refraction procedures performed by an ophthalmologist or optometrist. This bill would permit such an assistant to perform nonsubjective auto refraction, to perform preliminary subjective refraction procedures in connection with finalizing subjective refraction procedures performed by an ophthalmologist or optometrist, subject to certain conditions, and to perform A scan and B scan ultrasound testing. Existing law, the Optometry Practice Act, establishes the California State Board of Optometry in the Department of Consumer Affairs for the licensure and regulation of the practice of optometry. Existing law provides that the practice of optometry includes various functions relating to the visual system and the treatment and management of certain disorders and dysfunctions of the visual system, as well as the provision of rehabilitative optometric services, and doing certain things, including, but not limited to, the examination of the human eye or eyes. Existing law further authorizes an optometrist who is certified to use therapeutic pharmaceutical agents, as specified, to diagnose and treat certain conditions including, among others, hypotrichosis and blepharitis. Existing law sets forth requirements for a certified optometrist to become certified in the administration of immunizations, as defined. Existing law specifies that a violation of the act is a misdemeanor punishable by fine or imprisonment, as provided. This bill would revise what comprises the practice of optometry, including specific practices a certified optometrist may engage in, and would specify exceptions or limitations to that practice. The bill would permit a certified optometrist to use or prescribe topical and oral prescription and nonprescription therapeutic pharmaceutical agents that are not controlled substances and are not antiglaucoma agents or otherwise limited or excluded, as described. The bill would permit a certified optometrist to administer authorized immunizations after meeting the immunization certification requirements. By changing the scope of a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. This bill would incorporate additional changes to Section 2544 of the Business and Professions Code proposed by AB 1534 to be operative only if this bill and AB 1534 are enacted and this bill is enacted last. This bill would, contingent upon the enactment of AB 691, make additional changes to Section 3041 of the Business and Professions Code relating to the diagnostic use of certain laboratory tests or examinations for detecting the presence of the SARS-CoV-2 virus and to immunization certification, to be operative only if this bill and AB 691 are enacted.