Puerto Rico should consider giving optometrists the authority to prescribe certain medications, to benefit patients and improve competition among eye care providers, according to a statement issued by the Federal Trade Commission (FTC) staff and the Antitrust Division of the Department of Justice (DOJ). The agencies issued the statement in response to a request from Puerto Rico Rep. Jose L. Báez Rivera to enable optometrists in Puerto Rico to use and prescribe medications to diagnose and treat eye diseases. If the Puerto Rican legislature expands the services that optometrists can provide, optometrists will share in authority already granted to optometrists in all 50 states, the District of Columbia, and other U.S. territories.
Puerto Rico Senate Bill 991 would give optometrists who undergo additional training the authority to prescribe and use medications for the diagnosis and treatment of eye diseases. The expanded scope of practice would give authorized optometrists prescribing authority that is consistent with authority already held by ophthalmologists in Puerto Rico. The bill would also redefine the practice of optometry as “the examination, diagnosis, and treatment of any illness, condition, or disorder of the human visual system, including the eye or adnexa. The additional functions and procedures would be authorized for optometrists that pass a 120-hour course on the treatment and management of ophthalmic diseases. No optometrists would be permitted to perform surgery under the bill.
According to the Centers for Disease Control and Prevention (CDC), Puerto Rico has the highest percentage of adults in the United States and its territories reporting severe difficulty seeing or blindness. The FTC and DOJ determined that expanding the scope of the practice of optometrists beyond the current limits—maintaining only restrictions necessary to ensure patient health and safety—could facilitate beneficial competition and improve vision in Puerto Rico. The agencies asked Puerto Rican lawmakers to consider how additional competition could improve barriers to access and reduce the cost of eye care. Because optometrists are typically easier to visit than ophthalmologists and, in many areas, outnumber them, the agencies believe expanding the scope of optometrists’ practices could help them better serve as a first line of defense against eye disease.