New TMDP Disclosure Requirements for Eye Procedures 

The Texas Medical Disclosure Panel  (TMDP) recently approved changes to the lists of medical care and surgical procedures that require disclosure of specific risks and hazards. Effective August, 2018 as posted in the Texas Register on August 17, physicians providing these eye care services (list A, below) must disclose each of these specific risks and hazards to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure. List B names procedures requiring no disclosure of specific risks and hazards.

Updated lists across all specialties are found on the Texas Department of State Health Services website.


Texas Administrative Code
TITLE 25 HEALTH SERVICES
PART 7 TEXAS MEDICAL DISCLOSURE PANEL
CHAPTER 601 INFORMED CONSENT

RULE §601.2 Procedures Requiring Full Disclosure of Specific Risks and Hazards – List A

(f) Eye treatments and procedures.

(1) Eye muscle surgery.

  • Additional treatment and/or surgery.
  • Double vision.
  • Partial or total blindness.

(2) Surgery for cataract with or without implantation of intraocular lens.

  • Complications requiring additional treatment and/or surgery.
  • Need for glasses or contact lenses.
  • Complications requiring the removal of implanted lens.
  • Partial or total blindness.

(3) Retinal or vitreous surgery.

  • Complications requiring additional treatment and/or surgery.
  • Recurrence or spread of disease.
  • Partial or total blindness.

(4) Reconstructive and/or plastic surgical procedures of the eye and eye region, such as blepharoplasty, tumor, fracture, lacrimal surgery, foreign body, abscess, or trauma.

  • Blindness.
  • Nerve damage with loss of use and/or feeling to eye or other areas of face.
  • Painful or unattractive scarring.
  • Worsening or unsatisfactory appearance.
  • Dry eye.

(5) Photocoagulation and/or cryotherapy.

  • Complications requiring additional treatment and/or surgery.
  • Pain.
  • Partial or total blindness.

(6) Corneal surgery, such as corneal transplant, refractive surgery and pterygium.

  • Complications requiring additional treatment and/or surgery.
  • Pain.
  • Need for glasses or contact lenses.
  • Partial or total blindness.

(7) Glaucoma surgery by any method.

  • Complications requiring additional treatment and/or surgery.
  • Worsening of the glaucoma.
  • Pain.
  • Partial or total blindness.

(8) Removal of the eye or its contents (enucleation or evisceration).

  • Complications requiring additional treatment and/or surgery.
  • Worsening or unsatisfactory appearance.
  • Recurrence or spread of disease.

(9) Surgery for penetrating ocular injury, including intraocular foreign body.

  • Complications requiring additional treatment and/or surgery.
  • Possible removal of eye.
  • Pain.
  • Partial or total blindness. 

RULE §601.3 Procedures Requiring No Disclosure of Specific Risks and Hazards--List B

(f) Eye.


(1) Administration of topical, parenteral (such as IV), or oral drugs or pharmaceuticals, including, but not limited to, fluorescein angiography, orbital injection or periocular injections.
(2) Removal of extraocular foreign bodies.
(3) Chalazion excision.