Unprofessional Standards of
conduct. It shall be deemed unprofessional conduct for any licensed
optometrist in the Commonwealth to violate any statute or regulation governing
the practice of optometry or to fail to The board has the authority to
deny, suspend, revoke or otherwise discipline a licensee for a violation of the
following standards of conduct. A licensed optometrist shall:
1. Use in connection with the optometrist's name wherever it appears relating to the practice of optometry one of the following: the word "optometrist," the abbreviation "O.D.," or the words "doctor of optometry."
Maintain records on each patient for not less than five
years from the date of the most recent service rendered Disclose to the
board any disciplinary action taken by a regulatory body in another
3. Post in an area of the optometric office which is conspicuous to the public, a chart or directory listing the names of all optometrists practicing at that particular location.
4. Maintain patient records, perform procedures or make recommendations during any eye examination, contact lens examination or treatment as necessary to protect the health and welfare of the patient and consistent with requirements of 18VAC105-20-45.
5. Notify patients in the event the practice is to be terminated or relocated, giving a reasonable time period within which the patient or an authorized representative can request in writing that the records or copies be sent to any other like-regulated provider of the patient's choice or destroyed in compliance with requirements of § 54.1-2405 of the Code of Virginia on the transfer of patient records in conjunction with closure, sale, or relocation of practice.
6. Ensure his access to the practice location during hours in which the practice is closed in order to be able to properly evaluate and treat a patient in an emergency.
7. Provide for continuity of care in the event of an absence from the practice or, in the event the optometrist chooses to terminate the practitioner-patient relationship or make his services unavailable, document notice to the patient that allows for a reasonable time to obtain the services of another practitioner.
8. Comply with the provisions of § 32.1-127.1:03 of the Code of Virginia related to the confidentiality and disclosure of patient records and related to the provision of patient records to another practitioner or to the patient or his personal representative.
9. Treat or prescribe based on a bona fide practitioner-patient relationship consistent with criteria set forth in § 54.1-3303 of the Code of Virginia. A licensee shall not prescribe a controlled substance to himself or a family member other than Schedule VI as defined in § 54.1-3455 of the Code of Virginia. When treating or prescribing for self or family, the practitioner shall maintain a patient record documenting compliance with statutory criteria for a bona fide practitioner-patient relationship.
10. Comply with provisions of statute or regulation, state or federal, relating to the diversion, distribution, dispensing, prescribing or administration of controlled substances as defined in § 54.1-3401 of the Code of Virginia.
11. Not enter into a relationship with a patient that constitutes a professional boundary violation in which the practitioner uses his professional position to take advantage of the vulnerability of a patient or his family to include, but not limited to, actions that result in personal gain at the expense of the patient, a nontherapeutic personal involvement, or sexual conduct with a patient. The determination of when a person is a patient is made on a case-by-case basis with consideration given to the nature, extent, and context of the professional relationship between the practitioner and the person. The fact that a person is not actively receiving treatment or professional services from a practitioner is not determinative of this issue. The consent to, initiation of, or participation in sexual behavior or involvement with a practitioner by a patient does not change the nature of the conduct nor negate the prohibition.
12. Cooperate with the board or its representatives in providing information or records as requested or required pursuant to an investigation or the enforcement of a statute or regulation.
13. Not practice with an expired or unregistered professional designation.
14. Not violate or cooperate with others in violating any of the provisions of Chapters 1 (§ 54.1-100 et seq.), 24 (§ 54.1-2400 et seq.) or 32 (§ 54.1-3200 et seq.) of Title 54.1 of the Code of Virginia or regulations of the board.
18VAC105-20-45. Standards of practice.
A complete record of all examinations made of a patient shall
include a diagnosis and any treatment and shall also include but not be limited
to An optometrist shall legibly document in a patient record the
1. During a
comprehensive routine or medical eye
Case An adequate case history, including
the patient's chief complaint;
Acuity measure The performance of appropriate
Internal health evaluation The establishment of
an assessment or diagnosis; and d. External health evaluation; and e. Recommendations and directions to the patients,
including prescriptions d. A recommendation for an appropriate treatment
or management plan, including any necessary follow up.
2. During an initial contact lens examination:
a. The requirements of a
comprehensive routine or
medical eye examination as prescribed in subdivision 1 of this
b. Assessment of corneal curvature;
Assessment of corneal/contact lens relationship Evaluation
of contact lens fitting;
d. Acuity through the lens; and
e. Directions for the wear, care, and handling
and an explanation of the implications of contact lenses with
regard to eye health and vision.
3. During a follow-up contact lens examination:
Assessment Evaluation of corneal/contact
contact lens relationship fitting and anterior segment
b. Acuity through the lens; and
c. Such further instructions as
in subdivision 2 of this
subsection, as necessary for the individual patient.
4. In addition, the record of any examination shall include the signature of the attending optometrist and, if indicated, refraction of the patient.
B. The following information shall appear on a prescription for ophthalmic goods:
1. The printed name of the prescribing optometrist;
2. The address and telephone number at which the patient's records are maintained and the optometrist can be reached for consultation;
3. The name of the patient;
4. The signature of the optometrist;
5. The date of the examination and an expiration date, if medically appropriate; and
6. Any special instructions.
Sufficient information for complete and accurate filling
of an established contact lens prescription shall include but not be limited to
the power, the material or manufacturer or both, the base curve or appropriate
designation, the diameter when appropriate, and medically appropriate
expiration date An optometrist shall provide a patient with a copy of
the patient's contact lens prescription in accordance with the Federal Trade
Commission Contact Lens Rule (16 CFR Part 315).
D. A licensed optometrist shall provide a written prescription
for spectacle lenses
upon the request of the patient once all fees have been
paid. In addition, he shall provide a written prescription for contact lenses
upon the request of the patient once all fees have been paid and the
prescription has been established and the follow-up care completed. Follow-up
care will be presumed to have been completed if no reappointment is recommended
within 60 days after the last visit in accordance with the Federal Trade
Commission Eyeglass Rule (16 CFR Part 456).
E. Practitioners shall maintain a patient record for a minimum of five years following the last patient encounter with the following exceptions:
1. Records that have previously been transferred to another practitioner or health care provider or provided to the patient or his personal representative; or
2. Records that are required by contractual obligation or federal law to be maintained for a longer period of time.
F. From (one year after the effective date of this regulation), practitioners shall post information or in some manner inform all patients concerning the time frame for record retention and destruction. Patient records shall only be destroyed in a manner that protects patient confidentiality.