Puerto Rico’s Legislative Assembly is set to vote later this month on a bill that would allow TPAs for its optometrists.
Optometrists in Puerto Rico have tried at least six previous times—unsuccessfully—to gain authority to prescribe therapeutic pharmaceutical agents.

Will the seventh time be the charm?

Much is riding on this newest bill (P.S. 2634), which was submitted to the legislature in mid-May by Sen. Angel Martinez Santiago. Puerto Rico is the only jurisdiction in all of the United States and its territories where optometrists are not permitted to prescribe any topical agents for the treatment of ocular disease.

At stake: “The U.S. Armed Forces have adopted a new policy that only optometrists holding a therapeutic license can practice in their VA hospitals,” says Katerin A. Ortiz, O.D., who is the liaison from the Colegio de Optometras de Puerto Rico (its equivalent of a state association) to the AOA, as well as the Director of Pediatrics at the InterAmerican University of Puerto Rico School of Optometry.

This change in policy means that “Optometrists with a Puerto Rican license would therefore be given a lower rank than another optometrist with the same degree holding a license from the U.S.,” Dr. Ortiz says.

Last year, private practice optometrist Osvaldo Negrón, of Bayamon, P.R., posted a petition online to bring attention to the issue and to encourage the commonwealth’s government to allow therapeutic prescriptive authority for optometrists. At last count, the petition had nearly 1,200 electronic signatures.

Now, the current bill would amend the optometric law to allow optometrists in Puerto Rico to prescribe all topical drugs, including glaucoma meds, as long as the optometrist passes the Treatment and Management of Ocular Disease (TMOD) part of optometry boards, Dr. Ortiz says.

The bill is currently in the Senate. It must also be passed in the House of Representatives to be approved. The legislature is expected to make its decision by June 25.

The island commonwealth has a population of about 4 million, including more than 100 ophthalmologists and some 475 optometrists.