Mass. Gen. Laws ch. 112 § 66A
Any registered optometrist, qualified by examination for practice under the provisions of section sixty-eight subsequent to January first, nineteen hundred and eighty-four or duly certified in accordance with the provisions of section sixty-eight A may for the purpose of conducting an examination of the eye, and not for therapeutic purposes, utilize the topical application to the eye of diagnostic pharmaceutical agents; provided, however, that mydriatic agents shall not be administered to a person with an iris-fixed pseudophakes.
For purposes of this section and sections sixty-eight and sixty-eight A, the term "diagnostic pharmaceutical agents" shall mean any topical anesthetic, mydriatic, or cycloplegic drug, except atropine and phenylephrine hydrochloride in ten per cent concentration, suitable for ocular examination procedures.
If during the course of examining a patient, the optometrist determines the existence of: (a) ocular pressure greater than twenty-four MM, or (b) any unexplained loss of visual field, or (c) a failure on the part of the individual being examined to achieve 20/40 or better corrected vision in each eye, or (d) signs of disease, the patient shall be referred to a licensed physician, unless such condition has been previously evaluated by a physician or unless the optometrist reports in writing that such referral is not warranted and documents the reasons therefor on the records of such patient.
Mass. Gen. Laws ch. 112, § 66A