Section 1728 - Use of therapeutic pharmaceutical agents(a)(1) A licensee who employs an oral therapeutic pharmaceutical agent that might prove to have significant systemic adverse reactions or systemic side effects shall, in a manner consistent with Vermont law, ascertain the risk of systemic side effects through either a case history or by communicating with the patient's primary care provider.(2) The licensee shall also communicate with the patient's primary care provider, or with a physician skilled in diseases of the eye, when, in the professional judgment of the licensee, it is medically appropriate.(3) Any communication shall be noted in the patient's permanent record. The methodology of communication shall be determined by the licensee.(b)(1) If a glaucoma patient does not respond to up to three topically administered pharmaceutical agents within a reasonable time, the licensee shall refer the patient to a licensed ophthalmologist.(2) A glaucoma patient shall not be treated by an optometrist with more than three topically administered agents at any given time.(3) If an oral medication is required to obtain an adequate clinical response in a glaucoma patient, the licensee shall consult with a licensed ophthalmologist as soon as clinically prudent following initiation of the oral medication.(4) This subsection shall not require that the licensee transfer care of the patient to the consulting ophthalmologist, but does require that the patient be seen by the consulting ophthalmologist.Added 1993, No. 216 (Adj. Sess.), § 3; amended 2003, No. 108 (Adj. Sess.), § 5; 2009, No. 103 (Adj. Sess.) , § 13; 2019, No. 30, § 12.