Section 2.03 - Certification for Use of Therapeutic Pharmaceutical Agents (TPAs)(1)Methods of Obtaining Certification for Use of TPA. To obtain a certificate of qualification in the utilization of TPAs, licensees or applicants for licensure shall submit to the Board evidence of the completion of the education and examination required under M.G.L. c. 112, § 68B. Such evidence shall include, but not be limited to: (a) Satisfactory proof of graduation from a School or College of Optometry after January 1, 1994; or(b) Satisfactory proof of licensure in another jurisdiction with equivalent licensure standards to those of the Commonwealth granting the licensee or applicant authority to utilize TPAs.(2)Other Requirements for the use of TPA. Optometrists who are certified by the Board in the use of TPA agents must comply with the statutes and the Massachusetts Department of Public Health regulations governing the distribution of controlled substances, including the registration, written prescription, and documentation requirements under 105 CMR 700.00: Implementation of M.G.L. c. 94C.(3)Restrictions on Use of TPAs. Nothing in M.G.L. c. 112, §§ 66 through 73B or 246 CMR 1.00et seq. shall be construed as authorizing any Optometrist to: (a) Use any TPA which is listed, pursuant to Title 21, section 812 of the United States Code or M.G.L. c. 94C, as a controlled substance in Schedules II through V;(b) Use any pharmaceutical agent which is administered by means of subdermal injection, intramuscular injection, intravenous injection, subcutaneous injection or retrobulbar injection;(c) Use any pharmaceutical agent for the specific treatment of systemic disease; or(d) Perform any invasive surgical procedure.(4)Mandatory Referral of Patients to Physicians or Other Qualified Providers. Pursuant to M.G.L. c. 112, § 66B, if, during the course of examining or treating a patient with the aid of a DPA or TPA, an Optometrist, in the reasonable exercise of his or her professional judgment, determines the existence of signs of previously unevaluated disease which would require treatment which is not within the scope of optometric practice as defined in M.G.L. c. 112, § 66, that Optometrist shall refer the patient to a licensed physician or other qualified health care practitioner for appropriate evaluation and/or treatment.Amended by Mass Register Issue 1340, eff. 6/2/2017.