# COMAR Title 10 — Maryland Department of Health

## Subtitle 28 — Board of Examiners in Optometry

### Chapter 11 — Use of Diagnostic Pharmaceutical Agents

**Authority:** Health Occupations Article, §§11-101, 11-205, and 11-404, Annotated Code of Maryland

**Administrative History:** Effective date: May 14, 1990 (17:9 Md. R. 1090)

**Administrative History:** Regulation .01 amended effective July 31, 2017 (44:15 Md. R. 760)

**Administrative History:** Regulation .02A, B amended effective November 20, 1994 (21:33 Md. R. 1933); July 31, 2017 (44:15 Md. R. 760)

**Administrative History:** Regulation .03 amended effective March 4, 2002 (29:4 Md. R. 417)

**Administrative History:** Regulation .04 amended effective November 20, 1994 (21:33 Md. R. 1933)

**Administrative History:** Regulation .04D amended effective July 7, 2025 (52:13 Md. R. 656)

#### Regulation .01 Definitions.

*COMAR 10.28.11.01*

A. In this chapter, the following term has the meaning indicated.

B. Term Defined. “Optometric management of ocular disease” means the use of optometric services and techniques to determine the most appropriate and timely referral for ocular disease.

#### Regulation .02 Diagnostic Pharmaceutical Agents.

*COMAR 10.28.11.02*

A. An optometrist certified by the Board as qualified to administer diagnostic pharmaceutical agents may use the following agents:

  (1) Agents directly or indirectly affecting the pupil of the eye, including, but not limited to, the mydriatics and cycloplegics listed below:

    (a) Phenylephrine hydrochloride (2.5 percent);

    (b) Hydroxyamphetamine hydrobromide (1.0 percent);

    (c) Cyclopentolate hydrochloride (0.5—2.0 percent);

    (d) Tropicamide (0.5 and 1.0 percent);

    (e) Cyclopentolate hydrochloride (0.2 percent) with phenylephrine hydrochloride (1.0 percent);

    (f) Dapiprazole hydrochloride (0.5 percent);

    (g) Hydroxyamphetamine hydrobromide (1.0 percent) and tropicamide (0.25 percent); and

  (2) Agents directly or indirectly affecting the sensitivity of the cornea, including, but not limited to, the:

    (a) Topical anesthetics listed below:

      (i) Proparacaine hydrochloride (0.5 percent); and

      (ii) Tetracaine hydrochloride (0.5 percent);

    (b) Diagnostic topical anesthetic and dye combinations listed below:

      (i) Benoxinate hydrochloride (0.4 percent)—fluorescein sodium (0.25 percent); and

      (ii) Proparacaine hydrochloride (0.5 percent)—fluorescein sodium (0.25 percent).

B. The optometrist may use the diagnostic pharmaceutical agents listed in §A of this regulation in strengths not greater than the strengths indicated unless clinically indicated.

C. The optometrist may not dispense diagnostic pharmaceutical agents to patients for self-administration.

#### Regulation .03 Certification.

*COMAR 10.28.11.03*

A. The Board will certify an optometrist licensed to practice in Maryland as qualified to administer diagnostic pharmaceutical agents if the licensed optometrist meets one of the following criteria:

  (1) Graduation from an accredited school of optometry within 7 years before applying for certification in Maryland.

  (2) Certification to use diagnostic pharmaceutical agents in another state which included completion of not less than 70 credit hours in diagnostic pharmaceutical agents if the optometrist:

    (a) Submits to the Board proof of certification to use diagnostic pharmaceutical agents in the other state.

    (b) Submits to the Board documentation that the original certification included at least 70 credit hours in diagnostic pharmaceutical agents. This documentation may be from either:

      (i) The state board that granted the original certification;

      (ii) The college, university, association, or other sponsors of the 70 credit hours in diagnostic pharmaceutical agents; or

      (iii) Any other organization approved by the Board.

  (3) Successful completion of a course in diagnostic pharmaceutical agents of at least 70 credit hours given by an accredited college or faculty approved by the Board within 7 years before applying for certification in Maryland.

B. The credit hours taken for initial certification in diagnostic pharmaceutical agents may be included as part of the hours of continuing education required for biennial license renewal.

C. To complete the certification process, the optometrist shall submit proof of current certification in cardiopulmonary resuscitation to the Board.

#### Regulation .04 Renewal of Certification.

*COMAR 10.28.11.04*

A. An optometrist certified under this chapter shall complete 6 credit hours of continuing education every 2 years in the use of diagnostic pharmaceutical agents in the diagnosis and optometric management of ocular disease.

B. The 6 credit hours of continuing education relating to the use of diagnostic pharmaceutical agents required every 2 years to maintain certification may be included as part of the hours of continuing education required for biennial license renewal.

C. An optometrist is responsible for maintaining proficiency with the current CPR procedures as recommended by the American Heart Association.

D. The Board shall grant 3 continuing education hours for CPR recertification courses per biennial license renewal.

#### Regulation .05 Reporting.

*COMAR 10.28.11.05*

An optometrist certified to use diagnostic pharmaceutical agents shall report to the Board, on the form provided by the Board, any incident of adverse reaction to the administration of diagnostic pharmaceutical agents.