House panel approves bill that would expand drug-prescribing power of optometrists

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In one of the Capitol’s longest-running industry fights, a House panel Thursday approved a bill that would expand the drug-prescribing powers of optometrists — an idea that is fiercely opposed by ophthalmologists and other medical doctors.

Dubbed the “eye war,” the issue centers on whether optometrists should be able to prescribe oral medications. They now are limited to prescribing what are known as “topical” medications, such as drops or creams, and have to send patients to ophthalmologists for conditions requiring oral drugs.

The House Health Quality Subcommittee voted 10-3 to expand the optometrists’ powers, giving them an initial victory in a battle that will play out during the upcoming legislative session. 

Bill sponsor Matt Caldwell, R-Lehigh Acres, said optometrists are not currently allowed to practice to the full extent of their training. He also said optometrists are allowed to prescribe oral medications, to varying degrees, in 47 other states.

Opponents, however, contend that optometrists don’t have the same type of training as ophthalmologists and say the bill would not do enough to protect patients such as seniors, who might be on numerous medications and could have harmful reactions if drugs are not prescribed properly.

Stephen Schwartz, a Naples ophthalmologist, said doctors in his specialty receive years of hands-on training as they go through medical school and gain experience through such things as residencies and internships.

“You cannot learn this in a classroom,” Schwartz said.

But Kimberly Reed, an optometrist who is a faculty member at Nova Southeastern University, said optometrists are trained in the proper use of medications, including making sure patients don’t have harmful side effects. She disputed that expanded prescribing powers would threaten the quality of care provided to groups such as seniors and children.

“To think that we would treat those patients any differently is, I think, an unfair assumption,” Reed told the House panel.

Optometrists have not been able to convince lawmakers to approve similar bills in the past, but both sides appear to be preparing for a major fight during the session that starts March 5. Industry groups spent hundreds of thousands of dollars during last year’s elections, and they also have hired prominent lobbyists to push their positions.

The bill (HB 239) is slated to go next to the House Health & Human Services Committee. A similar measure (SB 278) has been filed in the Senate but has not gone before a committee.

Under the House proposal, optometrists would be required to complete a course and an exam before they would be allowed to prescribe oral medications. The Florida Optometric Association and the Florida Medical Association — two foes on the prescribing issue — would jointly develop and administer the course and exam.

While the House panel overwhelmingly approved the measure, some lawmakers expressed interest in tinkering with it. Rep. Kevin Rader, D-Delray Beach, voted against the bill, saying he didn’t think it should move forward without changes.

“I don’t really know of a strong public need for this,” Rader said.

Supporters, however, say giving the expanded powers to optometrists would expand access to care for patients. Caldwell said he would be willing to consider changes sought by the ophthalmologists, but he also noted the years of debate about the issue.

“This bill’s been around nearly as long as I’ve been alive,” said Caldwell, 31.

Update: The Florida Optometric Association praised the House Subcommittee on Health Quality for passing House Bill 239.   

“We are thrilled that House Bill 239 is moving forward and that it gained wide support in today’s House Subcommittee on Health Quality,” said Dr. Ken Lawson, FOA Legislative Chair.  “On behalf of the FOA, I want to thank the members of the committee, as well as Representative Caldwell, for sponsoring and supporting this good bill.  We look forward to the bill’s next hearing, and as the legislation makes its way through the process, to serving as a resource for all lawmakers on this critical issue.” 

“I thank my fellow house members for recognizing the importance of ensuring all Floridians are able to access the appropriate level of eye care from an optometrist,” said Representative Caldwell.  “With this legislation moving forward, the outdated law prohibiting optometrists from prescribing oral medication for the treatment of the eye is on its way out, and our state will be in a position to deliver quality eye care to all Floridians.”

Material from Jim Saunders of the News Service of Florida was used in this post.

Peter Schorsch is the President of Extensive Enterprises and is the publisher of some of Florida’s most influential new media websites, including,,, and Sunburn, the morning read of what’s hot in Florida politics. SaintPetersBlog has for three years running been ranked by the Washington Post as the best state-based blog in Florida. In addition to his publishing efforts, Peter is a political consultant to several of the state’s largest governmental affairs and public relations firms. Peter lives in St. Petersburg with his wife, Michelle, and their daughter, Ella.