Once again, optometrists in Puerto Rico have submitted a therapeutics bill (PS-259) to the legislature. Once again, the bill requests privileges for pharmacologic agents for the diagnosis, treatment and management of the eye and adnexa. This includes glaucoma drugs, certain oral drugs, removal of foreign bodies, insertion and removal of punctal plugs, and other non-invasive procedures. The bill specifically prohibits any kind of invasive surgery, including laser procedures.

Last year, a similar bill (PC-4476) was shot down in the legislature. Various groups came out to vociferously oppose that bill, including the Puerto Rico Department of Health, the College of Medicine, the Medical Association, the College of Opticians, and the American Academy of Ophthalmology.

Puerto Rico has a population of about 4 million, including about 175 ophthalmologists and some 475 optometrists.

Optometric scope of practice in Puerto Rico is far behind the times, the bill says. The practice of optometry needs to expand in order to reflect the latest scientific, technological and academic advances. But unlike O.D.s in the remainder of the United States, O.D.s in Puerto Rico cannot even dilate the eye.



As in last years bill, this bill would clarify who can and who cannot provide eye exams (such as optical chains) and would eliminate contract agreements in the employment of optometrists. (See Puerto Rico O.D.s Waging Civil War, August 2002.)