Prescribing patterns of optometrists newly licensed in therapeutic drug use in New York State

As part of the New York State law authorizing optometrists to use Therapeutic Pharmaceutical Agents (TPAs), the New York State Education Department commissioned a study to monitor and assess the prescribing patterns and competence of optometrists newly licensed to use TPAs. This report summarizes the findings of that study.

The database was obtained from more than 11,000 Patient Data Reporting Forms (PDRFs) returned by 535 optometrists, listing diagnosis, type(s) of medication(s) prescribed, treatment outcome, and possible adverse effects.

Of the more than 11,000 forms returned by 535 optometrists, 8,936 were first visits, with 5,828 follow-up visits scheduled. For all reported initial visits, only 89 patients required ophthalmological referral for secondary or tertiary care. No adverse drug reactions requiring intervention were reported. The most-frequent diagnoses treated by optometrists were related to allergies, superficial trauma, conjunctivitis (unspecified), and then blepharitis. The most commonly prescribed ophthalmic preparations as actually reported on the PDRFs were Polytrim (trimethoprim/ polymixin B), tobramycin (brand name and generic), TobraDex (tobramycin/dexamethasone), and Livostin (levocabastine).

When analyzed according to diagnosis, the data indicate that the prescribing patterns of the prescribing optometrists adhered to currently accepted clinical guidelines. Based on the available data and the lack of observed side effects, the use of topical medications to treat anterior-segment disease by optometrists in New York State appears to be safe, and should be of benefit to patients who seek care from optometrists.