{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/54.1-3222.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/54.1-3222.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/54.1-3222.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/54.1-3222.html"}],"law_id":54127,"edition_id":1,"section_id":54127,"structure_id":13079,"section_number":"54.1-3222","catch_line":"TPA certification; certification for treatment of diseases or abnormal conditions with therapeutic pharmaceutical agents (TPAs)","history":"1996, cc. 152, 158; 2004, c. 744; 2015, c. 355; 2018, c. 280; 2023, c. 268; 2025, cc. 391, 408.","full_text":"TPA certification shall enable an optometrist to prescribe and administer, within his scope of practice, Schedule II controlled substances consisting of hydrocodone in combination with acetaminophen and Schedules III through VI controlled substances and devices as set forth in the Drug Control Act (\u00a7 54.1-3400 et seq.) to treat diseases and abnormal conditions of the human eye and its adnexa as determined by the Board, within the following conditions:\n\n1\n\nTreatment with oral therapeutic pharmaceutical agents shall be limited to (i) analgesics included on Schedule II controlled substances as defined in § 54.1-3448 of the Drug Control Act (§ 54.1-3400 et seq.) consisting of hydrocodone in combination with acetaminophen, and analgesics included on Schedules III through VI, as defined in §§ 54.1-3450 and 54.1-3455 of the Drug Control Act, which are appropriate to alleviate ocular pain and (ii) other Schedule VI controlled substances as defined in § 54.1-3455 of the Drug Control Act appropriate to treat diseases and abnormal conditions of the human eye and its adnexa.2\n\nTherapeutic pharmaceutical agents shall include topically applied Schedule VI drugs as defined in § 54.1-3455 of the Drug Control Act (§ 54.1-3400 et seq.).3\n\nAdministration of therapeutic pharmaceutical agents by injection shall be limited to the treatment of chalazia by means of injection of a steroid included in Schedule VI controlled substances as set forth in § 54.1-3455 of the Drug Control Act (§ 54.1-3400 et seq.). A TPA-certified optometrist shall provide written evidence to the Board that he has completed a didactic and clinical training course provided by an accredited school or college of optometry that includes training in administration of TPAs by injection prior to administering TPAs by injection pursuant to this subdivision.4\n\nTreatment of angle closure glaucoma shall be limited to initiation of immediate emergency care.5\n\nTreatment of infantile or congenital glaucoma shall be prohibited.6\n\nTreatment through surgery or other invasive modalities shall not be permitted, except as provided in subdivision 3 or for treatment of emergency cases of anaphylactic shock with intramuscular epinephrine.7\n\nEntities permitted or licensed by the Board of Pharmacy to distribute or dispense drugs, including, but not limited to, wholesale distributors and pharmacists, shall be authorized to supply TPA-certified optometrists with therapeutic pharmaceutical agents.","order_by":null,"text":{"0":{"id":198649,"text":"TPA certification shall enable an optometrist to prescribe and administer, within his scope of practice, Schedule II controlled substances consisting of hydrocodone in combination with acetaminophen and Schedules III through VI controlled substances and devices as set forth in the Drug Control Act (\u00a7 54.1-3400 et seq.) to treat diseases and abnormal conditions of the human eye and its adnexa as determined by the Board, within the following conditions:","type":"section","prefixes":[""],"prefix":"","entire_prefix":"","prefix_anchor":"","level":1,"next_prefix":"1"},"1":{"id":198650,"text":"Treatment with oral therapeutic pharmaceutical agents shall be limited to (i) analgesics included on Schedule II controlled substances as defined in § 54.1-3448 of the Drug Control Act (§ 54.1-3400 et seq.) consisting of hydrocodone in combination with acetaminophen, and analgesics included on Schedules III through VI, as defined in §§ 54.1-3450 and 54.1-3455 of the Drug Control Act, which are appropriate to alleviate ocular pain and (ii) other Schedule VI controlled substances as defined in § 54.1-3455 of the Drug Control Act appropriate to treat diseases and abnormal conditions of the human eye and its adnexa.","type":"section","prefixes":["1"],"prefix":"1","entire_prefix":"1","prefix_anchor":"1","level":1,"prior_prefix":"","next_prefix":"2"},"2":{"id":198651,"text":"Therapeutic pharmaceutical agents shall include topically applied Schedule VI drugs as defined in § 54.1-3455 of the Drug Control Act (§ 54.1-3400 et seq.).","type":"section","prefixes":["2"],"prefix":"2","entire_prefix":"2","prefix_anchor":"2","level":1,"prior_prefix":"1","next_prefix":"3"},"3":{"id":198652,"text":"Administration of therapeutic pharmaceutical agents by injection shall be limited to the treatment of chalazia by means of injection of a steroid included in Schedule VI controlled substances as set forth in § 54.1-3455 of the Drug Control Act (§ 54.1-3400 et seq.). A TPA-certified optometrist shall provide written evidence to the Board that he has completed a didactic and clinical training course provided by an accredited school or college of optometry that includes training in administration of TPAs by injection prior to administering TPAs by injection pursuant to this subdivision.","type":"section","prefixes":["3"],"prefix":"3","entire_prefix":"3","prefix_anchor":"3","level":1,"prior_prefix":"2","next_prefix":"4"},"4":{"id":198653,"text":"Treatment of angle closure glaucoma shall be limited to initiation of immediate emergency care.","type":"section","prefixes":["4"],"prefix":"4","entire_prefix":"4","prefix_anchor":"4","level":1,"prior_prefix":"3","next_prefix":"5"},"5":{"id":198654,"text":"Treatment of infantile or congenital glaucoma shall be prohibited.","type":"section","prefixes":["5"],"prefix":"5","entire_prefix":"5","prefix_anchor":"5","level":1,"prior_prefix":"4","next_prefix":"6"},"6":{"id":198655,"text":"Treatment through surgery or other invasive modalities shall not be permitted, except as provided in subdivision 3 or for treatment of emergency cases of anaphylactic shock with intramuscular epinephrine.","type":"section","prefixes":["6"],"prefix":"6","entire_prefix":"6","prefix_anchor":"6","level":1,"prior_prefix":"5","next_prefix":"7"},"7":{"id":198656,"text":"Entities permitted or licensed by the Board of Pharmacy to distribute or dispense drugs, including, but not limited to, wholesale distributors and pharmacists, shall be authorized to supply TPA-certified optometrists with therapeutic pharmaceutical agents.","type":"section","prefixes":["7"],"prefix":"7","entire_prefix":"7","prefix_anchor":"7","level":1,"prior_prefix":"6"}},"ancestry":[{"id":13079,"edition_id":1,"name":"Certification for Administration of Therapeutic Pharmaceutical Agents (TPAs)","identifier":"5","label":"article","depth":4,"order_by":1,"parent_id":13078,"metadata":{},"date_created":"2026-06-26 03:44:14","date_modified":"2026-06-26 03:44:14","permalink":{"id":243073,"object_type":"structure","relational_id":13079,"identifier":"5","token":"54.1\/III\/32\/5","url":"\/54.1\/III\/32\/5\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13078,"edition_id":1,"name":"Optometry","identifier":"32","label":"chapter","depth":3,"order_by":1,"parent_id":12758,"metadata":{},"date_created":"2026-06-26 03:44:14","date_modified":"2026-06-26 03:44:14","permalink":{"id":242971,"object_type":"structure","relational_id":13078,"identifier":"32","token":"54.1\/III\/32","url":"\/54.1\/III\/32\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12758,"edition_id":1,"name":"Professions and Occupations Regulated by Boards Within the Department of Health Professions","identifier":"III","label":"subtitle","depth":2,"order_by":1,"parent_id":12754,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":241105,"object_type":"structure","relational_id":12758,"identifier":"III","token":"54.1\/III","url":"\/54.1\/III\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12754,"edition_id":1,"name":"Professions and Occupations","identifier":"54.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":239313,"object_type":"structure","relational_id":12754,"identifier":"54.1","token":"54.1","url":"\/54.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":54127,"structure_id":13079,"section_number":"54.1-3222","catch_line":"TPA certification; certification for treatment of diseases or abnormal conditions with therapeutic pharmaceutical agents (TPAs)","url":"\/54.1-3222\/","token":"54.1\/III\/32\/5\/54.1-3222","metadata":false},{"id":58604,"structure_id":13079,"section_number":"54.1-3223","catch_line":"Regulations relating to therapeutic pharmaceutical agents","url":"\/54.1-3223\/","token":"54.1\/III\/32\/5\/54.1-3223","metadata":false},{"id":70211,"structure_id":13079,"section_number":"54.1-3224","catch_line":"Denial, etc., of TPA certification; disciplinary actions; summary suspension under certain circumstances","url":"\/54.1-3224\/","token":"54.1\/III\/32\/5\/54.1-3224","metadata":false}],"next_section":{"id":58604,"structure_id":13079,"section_number":"54.1-3223","catch_line":"Regulations relating to therapeutic pharmaceutical agents","url":"\/54.1-3223\/","token":"54.1\/III\/32\/5\/54.1-3223","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/54.1-3222\/","history_text":"

This law was first created in 1996. The record of its establishment is cataloged in chapters 152<\/a> and 158<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 5 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 2004, chapter 744<\/a>; in 2015, chapter 355<\/a>; in 2018, chapter 280<\/a>; in 2023, chapter 268<\/a>; in 2025, chapters 391<\/a> and 408<\/a>.<\/p>","references":[{"id":69625,"section_number":"2.2-4002","catch_line":"Exemptions from chapter generally","order_by":null,"url":"\/2.2-4002\/"},{"id":84550,"section_number":"54.1-3200","catch_line":"Definitions","order_by":null,"url":"\/54.1-3200\/"},{"id":72925,"section_number":"54.1-3201","catch_line":"What constitutes practice of optometry","order_by":null,"url":"\/54.1-3201\/"},{"id":75273,"section_number":"54.1-3225","catch_line":"Certification to perform laser surgery","order_by":null,"url":"\/54.1-3225\/"},{"id":55719,"section_number":"54.1-3301","catch_line":"Exceptions","order_by":null,"url":"\/54.1-3301\/"},{"id":85347,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","order_by":null,"url":"\/54.1-3303\/"},{"id":59669,"section_number":"54.1-3401","catch_line":"Definitions","order_by":null,"url":"\/54.1-3401\/"},{"id":77665,"section_number":"54.1-3408","catch_line":"Professional use by practitioners","order_by":null,"url":"\/54.1-3408\/"}],"refers_to":[{"id":77846,"section_number":"54.1-3400","catch_line":"Citation","order_by":null,"url":"\/54.1-3400\/"},{"id":56998,"section_number":"54.1-3448","catch_line":"Schedule II","order_by":null,"url":"\/54.1-3448\/"},{"id":76280,"section_number":"54.1-3450","catch_line":"Schedule III","order_by":null,"url":"\/54.1-3450\/"},{"id":82814,"section_number":"54.1-3455","catch_line":"Schedule VI","order_by":null,"url":"\/54.1-3455\/"}],"permalink":{"id":243075,"object_type":"law","relational_id":54127,"identifier":"54.1-3222","token":"54.1\/III\/32\/5\/54.1-3222","url":"\/54.1-3222\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/54.1-3222\/","token":"54.1\/III\/32\/5\/54.1-3222","dublin_core":{"Title":"TPA certification; certification for treatment of diseases or abnormal conditions with therapeutic pharmaceutical agents (TPAs)","Type":"Text","Format":"text\/html","Identifier":"\u00a7 54.1-3222","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

TPA certification shall enable an optometrist<\/span> to prescribe and administer, within his scope of practice, Schedule II controlled substances consisting of hydrocodone in combination with acetaminophen and Schedules<\/span> III through VI controlled substances and devices as set forth in the Drug Control Act (\u00a7 54.1-3400<\/a> et seq.) to treat diseases and abnormal conditions of the human eye and its adnexa as determined by the Board<\/span>, within the following conditions:<\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Treatment with oral therapeutic pharmaceutical agents shall be limited to (i) analgesics included on Schedule II controlled substances as defined in § 54.1-3448<\/a> of the Drug Control Act (§ 54.1-3400<\/a> et seq.) consisting of hydrocodone in combination with acetaminophen, and analgesics included on Schedules<\/span> III through VI, as defined in §§ 54.1-3450<\/a> and 54.1-3455<\/a> of the Drug Control Act, which are appropriate to alleviate ocular pain and (ii) other Schedule VI controlled substances as defined in § 54.1-3455<\/a> of the Drug Control Act appropriate to treat diseases and abnormal conditions of the human eye and its adnexa. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Therapeutic pharmaceutical agents shall include topically applied Schedule VI drugs as defined in § 54.1-3455<\/a> of the Drug Control Act (§ 54.1-3400<\/a> et seq.). <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Administration of therapeutic pharmaceutical agents by injection shall be limited to the treatment of chalazia by means of injection of a steroid included in Schedule VI controlled substances as set forth in § 54.1-3455<\/a> of the Drug Control Act (§ 54.1-3400<\/a> et seq.). A TPA-certified optometrist<\/span> shall provide written evidence<\/span> to the Board<\/span> that he has completed a didactic and clinical training course provided by an accredited school or college of optometry that includes training in administration of TPAs by injection prior to administering TPAs by injection pursuant to this subdivision. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Treatment of angle closure glaucoma shall be limited to initiation of immediate emergency care. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> Treatment of infantile or congenital glaucoma shall be prohibited. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> Treatment through surgery or other invasive modalities shall not be permitted, except as provided in subdivision 3 or for treatment of emergency cases of anaphylactic shock with intramuscular epinephrine. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> Entities permitted or licensed by the Board<\/span> of Pharmacy to distribute or dispense drugs, including, but not limited to, wholesale distributors and pharmacists, shall be authorized to supply TPA-certified optometrists<\/span> with therapeutic pharmaceutical agents. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nTPA CERTIFICATION; CERTIFICATION FOR TREATMENT OF DISEASES OR ABNORMAL\nCONDITIONS WITH THERAPEUTIC PHARMACEUTICAL AGENTS (TPAS) (\u00a7 54.1-3222)\n\nTPA certification shall enable an optometrist to prescribe and administer,\nwithin his scope of practice, Schedule II controlled substances consisting of\nhydrocodone in combination with acetaminophen and Schedules III through VI\ncontrolled substances and devices as set forth in the Drug Control Act (\u00a7\n54.1-3400 et seq.) to treat diseases and abnormal conditions of the human eye\nand its adnexa as determined by the Board, within the following conditions:\n\n1. Treatment with oral therapeutic pharmaceutical agents shall be limited to (i)\nanalgesics included on Schedule II controlled substances as defined in §\n54.1-3448 of the Drug Control Act (§ 54.1-3400 et seq.) consisting of\nhydrocodone in combination with acetaminophen, and analgesics included on\nSchedules III through VI, as defined in §§ 54.1-3450 and 54.1-3455 of\nthe Drug Control Act, which are appropriate to alleviate ocular pain and (ii)\nother Schedule VI controlled substances as defined in § 54.1-3455 of the\nDrug Control Act appropriate to treat diseases and abnormal conditions of the\nhuman eye and its adnexa.\n\n2. Therapeutic pharmaceutical agents shall include topically applied Schedule VI\ndrugs as defined in § 54.1-3455 of the Drug Control Act (§ 54.1-3400\net seq.).\n\n3. Administration of therapeutic pharmaceutical agents by injection shall be\nlimited to the treatment of chalazia by means of injection of a steroid included\nin Schedule VI controlled substances as set forth in § 54.1-3455 of the\nDrug Control Act (§ 54.1-3400 et seq.). A TPA-certified optometrist shall\nprovide written evidence to the Board that he has completed a didactic and\nclinical training course provided by an accredited school or college of\noptometry that includes training in administration of TPAs by injection prior to\nadministering TPAs by injection pursuant to this subdivision.\n\n4. Treatment of angle closure glaucoma shall be limited to initiation of\nimmediate emergency care.\n\n5. Treatment of infantile or congenital glaucoma shall be prohibited.\n\n6. Treatment through surgery or other invasive modalities shall not be\npermitted, except as provided in subdivision 3 or for treatment of emergency\ncases of anaphylactic shock with intramuscular epinephrine.\n\n7. Entities permitted or licensed by the Board of Pharmacy to distribute or\ndispense drugs, including, but not limited to, wholesale distributors and\npharmacists, shall be authorized to supply TPA-certified optometrists with\ntherapeutic pharmaceutical agents.\n\nHISTORY: 1996, cc. 152, 158; 2004, c. 744; 2015, c. 355; 2018, c. 280; 2023, c.\n268; 2025, cc. 391, 408.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}