The continuing impact of treatment of eye disease on optometric practice in Missouri.

Background: This study is a follow-up to a study performed in 1991 to determine the continuing impact of the use by optometrists in Missouri of therapeutic agents (TPA) to treat eye diseases.

Methods: Sixty-four percent of the Missouri optometrists certified to use therapeutic pharmaceutical agents responded to a 1995 questionnaire.

Results: More than 90 percent of those responding prescribe all categories of topical agents, while oral agents are used at lower percentages. Almost two-thirds of optometrists are registered with the Drug Enforcement Administration to prescribe controlled substances. The median number of therapeutic prescriptions written per year was 240, an increase of 67 percent from the previous study. More than half of the respondents now receive in-office detailing by drug company representatives. A small percent of optometrists have hospital clinical privileges and about one-fourth have privileges in nursing homes.

Conclusions: The percentage of TPA-certified optometrists residing and practicing in Missouri has risen from one-half to slightly more than three-fourths of practitioners in a 4-year time period. This increase, coupled with the demonstrated increase in therapeutic prescriptions written, enhanced exposure to in-office detailing, and recent amendment of the optometry law to include the management of glaucoma bodes well for the delivery of primary eye care to citizens of the state.