Optometrists in Alaska can now prescribe most oral and injectable ophthalmic drugs for their patients following passage of House Bill 113 on September 7. For nearly a decade, the Alaska Optometric Association (AKOA) had been trying to expand O.D.s scope of practice. This new law stipulates that licensed optometrists in Alaska may prescribe a nontopical drug if it is:

Prescribed and used for the treatment of ocular diseases or conditions, ocular adnexal diseases or conditions, or for emergency anaphylaxis.

Not a schedule IA, IIA or VIA controlled substance.

Prescribed in a quantity that does not exceed four days of use if it is a controlled substance.

Not injected, unless the injection is for emergency anaphylaxis and is not injected into the ocular globe of the eye.

Not a derivative of Clostridium botulinum (e.g., Botox).

Additionally, licensed optometrists must have both a defined physician-patient relationship and a current Federal Drug Enforcement Administration registration number to legally prescribe these drugs.

Those who benefit most from this law are the patients, says Tracy Oman, executive director of the AKOA. Alaska is quite unique. Because of its rural landscape and sparse population, many individuals have to travel great distances to get a prescription from an ophthalmologist, she says.

In the entire state of Alaskawhich is twice the size of Texasthere are approximately 109 optometrists and just 20 ophthalmologists. So, this legislation provides patients with much better access to care and medication, Ms. Oman says.

Optometrist Michael Bennett, president of the AKOA, says the law is long overdue. For quite some time, the legislation was widely opposed by ophthalmologists across America, he contends. Few physicians in the continental United States entirely understand just how remote the landscape of Alaska is. This geographic limitation often can result in poor patient care.

The law also requires Alaska optometrists to pass written and practical examinations in ocular pharmacology before they can prescribe oral and injectable drugs. Because of this mandate, Dr. Bennett believes that the legislation most likely would not take effect any earlier than spring 2008.

Once the legislation is fully enacted next year, we will be able to provide an increased level of care to our patients, Dr. Bennett says.