22 Tex. Admin. Code § 279.1 - Contact Lens Examination
(a) The optometrist
or therapeutic optometrist shall, in the initial examination of the patient for
whom contact lenses are prescribed:
(1)
Personally make and record, if possible, the following findings of the
conditions of the patient as required by § 351.353 of the Act:
(A) biomicroscopy examination (lids, cornea,
sclera, etc.), using a binocular microscope;
(B) internal ophthalmoscopic examination
(media, fundus, etc.), using an ophthalmoscope or biomicroscope with fundus
condensing lenses; videos and photographs may be used only for documentation
and consultation purposes but do not fulfill the internal ophthalmoscopic
examination requirement; and
(C)
subjective findings, far point and near point;
(2) Either personally make and record or
authorize an assistant present in the same office with the optometrist or
therapeutic optometrist to make and record the following findings required by
§ 351.353 of the Act. The authorization for assistants to make and record
the following findings does not relieve the optometrist or therapeutic
optometrist of professional responsibility for the proper examination and
recording of each finding required by § 351.353 of the Act:
(A) case history (ocular, physical,
occupational, and other pertinent information);
(B) visual acuity;
(C) static retinoscopy O.D., O.S., or
autorefractor;
(D) assessment of
binocular function;
(E) amplitude
or range of accommodation;
(F)
tonometry; and
(G) angle of vision,
to right and to left.
(3) Personally notate in the patient's record
the reasons why it is not possible to make and record the findings required in
subsection (a) of this section;
(4)
When a follow-up visit is medically indicated, schedule the follow-up visit
within 30 days of the contact lens fitting, and inform the patient on the
initial visit regarding the necessity for the follow-up care; and
(5) Personally or authorize an assistant to
instruct the patient in the proper care of lenses.
(b) The optometrist or therapeutic
optometrist and assistants shall observe proper hygiene in the handling and
dispensing of the contact lenses and in the conduct of the examination. Proper
hygiene includes sanitary office conditions, running water in the office where
contact lenses are dispensed, and proper sterilization of diagnostic lenses and
instruments.
(c) The fitting of
contact lenses may be performed only by a licensed physician, optometrist, or
therapeutic optometrist. Ophthalmic dispensers may make mechanical adjustments
to contact lenses and dispense contact lenses only after receipt of a fully
written contact lens prescription from a licensed optometrist, therapeutic
optometrist, or a licensed physician. An ophthalmic dispenser shall make no
measurement of the eye or the cornea or evaluate the physical fit of the
contact lenses, by any means whatever, subject solely and only to the exception
contained in the § 351.005 of the Act.
(d) The willful or repeated failure or
refusal of an optometrist or therapeutic optometrist to comply with any of the
requirements in the Act, § 351.353 and § 351.359, shall be considered
by the board to constitute prima facie evidence that the licensee is unfit or
incompetent by reason of negligence within the meaning of the Act, §
351.501(a)(2), and shall be sufficient ground for the filing of charges to
cancel, revoke, or suspend the license. The charges shall state the specific
instances in which it is alleged that the rule was not complied with. After the
board has produced evidence of the omission of a finding required by §
351.353, the burden shifts to the licensee to establish that the making and
recording of the findings was not possible.
Notes
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