In this chapter, the following terms have the meanings indicated. Terms Defined. “Adverse drug reaction” means a physical or psychological reaction experienced by a patient which: Results from the administration of diagnostic or therapeutic pharmaceutical agents; Poses a threat to the health of the patient; and Requires treatment or medical intervention. “Adverse reaction” means the unintended or unexpected effect of treatment on a patient caused by or resulting from: An adverse drug reaction; The removal of a superficial foreign body from the eye; or The ordering of a laboratory test. “Board” means the Board of Examiners in Optometry. “Diagnostic pharmaceutical agent (DPA)” means a medication that: Directly or indirectly affects the pupil of the eye as defined in COMAR 10.28.11; Directly or indirectly affects the sensitivity of the cornea as defined in COMAR 10.28.11; or Stains the ocular surface. “Ophthalmologist” means a physician who practices in the specialty of ophthalmology and who is licensed by the Maryland Board of Physicians. “Primary open angle glaucoma” means glaucomatous changes characterized by: Adult onset; The presence of open, normal appearing angles as demonstrated by gonioscopy, and not otherwise explained; and One or more of the following: The appearance of optic disc damage or optic nerve fiber layer damage as evidenced by the size or shape of the optic disc cup, thinning or notching of the optic disc rim, progressive changes in the appearance of the optic disc cup, optic disc hemorrhage, or nerve fiber layer defects, seen clinically or via imaging; The presence of abnormalities in the visual field including arcuate defect, nasal step, paracentral scotoma, or general depression, in the absence of other causes or explanations for a visual field defect; or Intraocular pressure that is thought to pose a threat to the health of the optic nerve. “Secretary” means the Secretary of Health. “Therapeutic pharmaceutical agent (TPA)” means a medication used for the treatment of a disease or condition of the eye as specified in Health Occupations Article, §11-404.2, Annotated Code of Maryland. “Therapeutically certified optometrist” means a licensed optometrist who has fulfilled the requirements of the Board and is certified by the Board to use therapeutic pharmaceutical agents in the practice of optometry and provides therapeutic services to patients in Maryland. “TPA record” means the optometrist's documentation of a patient's visit, the result of which involved the prescribing of medication or the performance of a procedure for treatment of a medical eye condition by a therapeutically certified optometrist. “Universal precautions” has the meaning stated in COMAR 10.06.01.02B(10).