201 KAR 5:110. Expanded therapeutic procedures.

 

      RELATES TO: KRS 320.210(2) and 320.240(4), (5), and (7)

      STATUTORY AUTHORITY: KRS 320.210(2) and 320.240(4), (5), and (7)

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 320.240(4) grants the Kentucky Board of Optometric Examiners the authority to promulgate reasonable regulations and the board’s administrative regulations shall include the classification and licensure of optometrists by examination and credentials. KRS 320.240(5) requires a therapeutically licensed optometrist to meet educational and competence criteria set forth by the board in order to perform expanded therapeutic procedures, and evidence of proof of continuing competency shall be determined by the board. This administrative regulation establishes the educational and competence criteria necessary for a therapeutically licensed optometrist to perform expanded therapeutic procedures.

 

      Section 1. Qualifications for a Kentucky Licensed Optometrist to be Credentialed to Utilize Expanded Therapeutic Procedures. A Kentucky licensed optometrist shall be credentialed to perform expanded therapeutic procedures if:

      (1) The applicant provides proof that the applicant:

      (a) Holds an active license in good standing by another state;

      (b) Is also credentialed by that state to perform expanded therapeutic procedures; and

      (c) The requirements in the state of licensure for performing expanded therapeutic procedures meet or exceed the requirements in this section; or

      (2)(a) The optometrist is currently therapeutically licensed in Kentucky; and

      (b). Provides proof of completion of a course approved by the Board that includes:

      1. The following didactic instruction:

Class room instruction covering:

      a. Laser Physics, Hazards and Safety;

      b. Biophysics of laser;

      c. Laser application in Clinical Optometry;

d. Laser Tissue Interactions;

      e. Laser Indications, Contraindications and Potential Complications;

      f. Gonioscopy;

      g. Laser Therapy for Open Angle Glaucoma;

      h. Laser Therapy for Angle Closure Glaucoma;

      i. Posterior Capsulotomy;

      j. Common complications: Lids, Lashes, Lacrimal;

      k. Medicolegal Aspects of Anterior Segment Procedures;

      l. Peripheral Iridotomy;

      m. Laser Trabeculoplasty

      n. Minor surgical procedures;

      o. Overview of surgical instruments, Asepsis and OSHA;

      p. The surgical anatomy of the Eyelids;

      q. Emergency Surgical Procedures;

      r. Chalazion Management;

      s. Epilumeninesence Microscopy;

      t. Suture techniques;

      u. Local anesthesia: techniques and complications;

      v. Anaphylaxsis and other office emergencies;

      w. Radiofrequency Surgery; and

      x. Post-operative Wound Care;

      2. Clinical or Laboratory experience including:

      a. Video Tape Demonstration;

      b. In Vitro Observation or participation;

      c. In Vivo Observation; and

      d. A formal Clinical or Laboratory Practical Examination; and

      3. Passage of a written test utilizing the National Board of Examiners in Optometry format.

      (3) A board approved course shall be:

      (a) Provided by an accredited optometry or medical school;

      (b) Taught by full-time or adjunct faculty members of an accredited optometry or medical school;

      (c) A minimum of thirty-two (32) clock hours in length; and

      (d) Sponsored by an organization that meets the standards of 201 KAR 5:030.

 

      Section 2. Qualifications for a New Applicant for Licensure to be Credentialed to Utilize Expanded Therapeutic Procedures. A new applicant for licensure as an optometrist shall be credentialed to perform expanded therapeutic procedures if:

      (1) The applicant provides proof that the applicant has graduated from an optometry school whose program includes all of the education, training, and testing requirements established in Section 1; or

      (2) By the end of the first licensure renewal period, the licensee shall provide proof of compliance with Section 1 of this administrative regulation.

 

      Section 3. Qualifications for an Applicant for Licensure by Endorsement to be Credentialed to Utilize Expanded Therapeutic Procedures. An applicant for licensure by endorsement shall be credentialed to perform expanded therapeutic procedures in Kentucky if:

      (1) The applicant provides proof that:

      (a) The applicant holds an active license in good standing by another state;

      (b) Is credentialed by that state to perform expanded therapeutic procedures; and

      (c) The requirements in the state of licensure for performing expanded therapeutic procedures meet or exceed the requirements in Section 1; or

      (2) By the end of the first licensure renewal period, the licensee shall provide proof of compliance with Section 1 of this administrative regulation.

 

      Section 4. Qualifications for an Optometrist to be Credentialed to Utilize Expanded Therapeutic Laser Procedures. (1) An optometrist credentialed in Kentucky to perform expanded therapeutic procedures shall be credentialed to perform expanded therapeutic laser procedures if the optometrist:

      (a) Provides documentation to the board from a board approved preceptor indicating that the optometrist has:

      1. Performed the anterior segment laser procedure in the presence of the board approved qualified preceptor; and

      2. Demonstrated clinical proficiency in the performance of the procedure on a living human eye to the satisfaction of the board approved qualified preceptor.

      (2) The board approved qualified preceptor shall document in writing the preceptor’s observations of the optometrist’s performance and state that the optometrist has satisfactorily demonstrated his knowledge and qualifications in the performance of the procedure.

      (3) A board approved qualified preceptor shall be:

      (a) A licensed optometrist or ophthalmologist whose license is in good standing;

      (b) A full-time or adjunct faculty member of an accredited optometry or medical school; and

      (c) Credentialed in the expanded therapeutic procedure or expanded therapeutic laser procedure that the preceptor is teaching.

 

      Section 5. Prohibitions and Referrals.

      (1) Performing expanded therapeutic procedures without credentialing based upon the education requirements outlined in this administrative regulation shall be grounds for discipline pursuant to the requirements of KRS 320.310(1).

      (2) Injections into the posterior segment/chamber or retinal tissue to treat any macular or retinal disease shall not be permitted under KRS 320.210(2)(b)16.

      (3) Any eyelid or adnexal lesion found to be malignant shall be referred to a practitioner trained and qualified to treat those lesions.

 

      Section 6. Annual Course of Study. (1) In addition to the continuing education credit hours required by 201 KAR 5:030 Section 1(1) and (2)(a) and (b), an optometrist who is credentialed by the Board to perform expanded therapeutic procedures shall attend a minimum of five (5) additional credit hours in expanded therapeutic procedures, for a total of twenty (20) continuing education credits.

      (2) None of the five (5) required contact credit hours in expanded therapeutic procedures may be obtained through the internet.

 

      Section 7. Incorporation by Reference. (1) The following material is incorporated by reference:

      (a) “Application for Expanded Therapeutic Procedures Course”, August 2011;

      (b) “Application for Kentucky Licensed Optometrist to be Credentialed to Utilize Expanded Therapeutic Procedures”, August 2011;

      (c) “Application for New Applicant to be Credentialed to Utilize Expanded Therapeutic Procedures”, August 2011;

      (d) “Application for Endorsement to be Credentialed to Utilize Expanded Therapeutic Procedures”, August 2011;

      (e) “Preceptor Approval Form”, August 2011;

      (f) “Preceptor Evaluation of Expanded Therapeutic Laser Procedure”, August 2011; and

      (g) “Application to Utilize Expanded Therapeutic Laser Procedure(s)”, August 2011.

      (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Optometric Examiners, 163 W. Short St., Suite 550, Lexington, Kentucky 40507, telephone (859) 246-2744, Monday through Friday, 8:00 a.m. to 4:30 p.m. (38 Ky.R. 167; 621; 872; 11-4-2011.)