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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>54127</law_id><section_number>54.1-3222</section_number><catch_line>TPA certification; certification for treatment of diseases or abnormal conditions with therapeutic pharmaceutical agents (TPAs)</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>2.2-4002</reference><reference>54.1-3200</reference><reference>54.1-3201</reference><reference>54.1-3225</reference><reference>54.1-3301</reference><reference>54.1-3303</reference><reference>54.1-3401</reference><reference>54.1-3408</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="54.1">Professions and Occupations</unit><unit label="subtitle" level="2" order_by="1" identifier="III">Professions and Occupations Regulated by Boards Within the Department of Health Professions</unit><unit label="chapter" level="3" order_by="1" identifier="32">Optometry</unit><unit label="article" level="4" order_by="1" identifier="5">Certification for Administration of Therapeutic Pharmaceutical Agents (TPAs)</unit></structure><text>
						<section><p>TPA certification shall enable an <span class="dictionary">optometrist</span> to prescribe and administer, within his scope of practice, Schedule II controlled substances consisting of hydrocodone in combination with acetaminophen and <span class="dictionary">Schedules</span> III through VI controlled substances and devices as set forth in the Drug Control Act (&#xA7;&#xA0;<a class="law" title="Citation" href="/54.1-3400/">54.1-3400</a> et seq.) to treat diseases and abnormal conditions of the human eye and its adnexa as determined by the <span class="dictionary">Board</span>, within the following conditions:</p></section>
						<section id="1"><p><span class="prefix-number">1.</span> Treatment with oral therapeutic pharmaceutical agents shall be limited to (i) analgesics included on Schedule II controlled substances as defined in &#xA7; <a class="law" title="Schedule II" href="/54.1-3448/">54.1-3448</a> of the Drug Control Act (&#xA7; <a class="law" title="Citation" href="/54.1-3400/">54.1-3400</a> et seq.) consisting of hydrocodone in combination with acetaminophen, and analgesics included on <span class="dictionary">Schedules</span> III through VI, as defined in &#xA7;&#xA7; <a class="law" title="Schedule III" href="/54.1-3450/">54.1-3450</a> and <a class="law" title="Schedule VI" href="/54.1-3455/">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 &#xA7; <a class="law" title="Schedule VI" href="/54.1-3455/">54.1-3455</a> of the Drug Control Act appropriate to treat diseases and abnormal conditions of the human eye and its adnexa. <a id="paragraph-198650" class="section-permalink" href="https://vacode.org/54.1-3222/#1"><i class="fa fa-link"/></a></p></section>
						<section id="2"><p><span class="prefix-number">2.</span> Therapeutic pharmaceutical agents shall include topically applied Schedule VI drugs as defined in &#xA7; <a class="law" title="Schedule VI" href="/54.1-3455/">54.1-3455</a> of the Drug Control Act (&#xA7; <a class="law" title="Citation" href="/54.1-3400/">54.1-3400</a> et seq.). <a id="paragraph-198651" class="section-permalink" href="https://vacode.org/54.1-3222/#2"><i class="fa fa-link"/></a></p></section>
						<section id="3"><p><span class="prefix-number">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 &#xA7; <a class="law" title="Schedule VI" href="/54.1-3455/">54.1-3455</a> of the Drug Control Act (&#xA7; <a class="law" title="Citation" href="/54.1-3400/">54.1-3400</a> et seq.). A <span class="dictionary">TPA-certified optometrist</span> shall provide written <span class="dictionary">evidence</span> to the <span class="dictionary">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. <a id="paragraph-198652" class="section-permalink" href="https://vacode.org/54.1-3222/#3"><i class="fa fa-link"/></a></p></section>
						<section id="4"><p><span class="prefix-number">4.</span> Treatment of angle closure glaucoma shall be limited to initiation of immediate emergency care. <a id="paragraph-198653" class="section-permalink" href="https://vacode.org/54.1-3222/#4"><i class="fa fa-link"/></a></p></section>
						<section id="5"><p><span class="prefix-number">5.</span> Treatment of infantile or congenital glaucoma shall be prohibited. <a id="paragraph-198654" class="section-permalink" href="https://vacode.org/54.1-3222/#5"><i class="fa fa-link"/></a></p></section>
						<section id="6"><p><span class="prefix-number">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. <a id="paragraph-198655" class="section-permalink" href="https://vacode.org/54.1-3222/#6"><i class="fa fa-link"/></a></p></section>
						<section id="7"><p><span class="prefix-number">7.</span> Entities permitted or licensed by the <span class="dictionary">Board</span> of Pharmacy to distribute or dispense drugs, including, but not limited to, wholesale distributors and pharmacists, shall be authorized to supply <span class="dictionary">TPA-certified optometrists</span> with therapeutic pharmaceutical agents. <a id="paragraph-198656" class="section-permalink" href="https://vacode.org/54.1-3222/#7"><i class="fa fa-link"/></a></p></section></text><history>1996, cc. 152, 158; 2004, c. 744; 2015, c. 355; 2018, c. 280; 2023, c. 268; 2025, cc. 391, 408.</history><metadata></metadata></law>
