1. Notwithstanding the provisions of subsection 1 of section 336.010, any optometrist who is not certified to use either diagnostic or therapeutic pharmaceutical agents shall continue to be prohibited from administering, dispensing, or prescribing the respective pharmaceutical agents unless the optometrist has completed an approved course of study and has been certified by the board. Such status shall be noted on the license at each renewal.

2. Any optometrist authorized by the board to administer only diagnostic pharmaceutical agents shall refer a patient to a physician licensed under chapter 334 if an examination of the eyes indicates a condition, including reduced visual acuity, which requires medical treatment, further medical diagnosis, or further refraction. This referral is not required on known or previously diagnosed conditions. The record of the referral in the optometrist’s notes shall have the standing of any business record. Any optometrist violating this section shall be subject to the provisions of section 336.110.

3. An optometrist’s prescriptions for therapeutic pharmaceutical agents shall be dispensed by a pharmacist licensed under chapter 338. When therapeutic pharmaceutical agents are dispensed by an optometrist, the provisions of section 338.059 shall apply.

4. An optometrist certified to use pharmaceutical agents shall be held to the standard of care in the use of pharmaceutical agents in the optometrist’s diagnosis and treatment as are physicians licensed by the Missouri state board of registration for the healing arts, who exercise that degree of skill and learning ordinarily used under the same or similar circumstances by physicians and surgeons engaged in the practice of medicine.

5. The board may adopt reasonable rules and regulations providing for the examination and certification of optometrists who apply to the board for authority to administer and prescribe pharmaceutical agents in the practice of optometry.