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Professional Practice FAQ’s


Scope of Practice

Can an optician neutralize a prescription from a patient’s existing eyeglasses for the purposes of fitting contact lenses?

Yes. An optician may neutralize the prescription from a patient’s current pair of eyeglasses in order to fit the patient with contact lenses and the neutralization must be noted in the patient’s health record. If the prescription cannot be adequately obtained by neutralization (i.e. lenses are too scratched, frame is broken and does not support the lenses in the proper position in front of the eye, etc.) the optician may not use that prescription to reproduce another pair of eyeglasses or fit the patient with contact lenses and must obtain a valid prescription from an authorized prescriber.

Before neutralization can occur, it is essential for the optician to explain to the patient the importance of having regular eye examinations because such examinations may reveal the necessity for further correction.

Do ophthalmic prescriptions expire?

No. The College of Opticians does not stipulate an expiry or “best before” date for prescriptions but does endorse the eye examination frequency recommended by the Canadian Ophthalmological Society.

The College of Optometrists of Ontario’s current regulatory and professional standards of practice for optometrists in Ontario provides that, when an optometrist specifies a “fill before” date on a prescription, this information is communicated to the patient so that the patient understands why it is not appropriate to fill the prescription after the specified date. However, the final decision of whether to have the prescription updated rests with the patient and with the licensed health care provider who is filling the prescription.

When a patient asks an optician to fill a prescription, it is the optician’s professional responsibility to determine whether the prescription may need to be updated, to explain this to the patient and to provide recommendations using his or her professional judgment. Opticians are advised to record these recommendations in the patient’s health record. The primary consideration should always be the best interests of the patient. At no time is an Optician required or expected to fill a prescription unless he or she has decided it is in the best interests of the patient to do so.

Does an optician have the right to refuse to dispense a supply of contact lenses to an existing patient who refuses to comply with the Optician’s recommended follow-up schedule?

Yes. The primary consideration should always be the best interests of the patient. At no time is an optician required or expected to fill a prescription unless he or she has decided it is in the best interests of the patient to do so.

Can an optician dispense a supply of contact lenses to an existing patient who refuses to undergo a new eye examination?

Yes. The optician is responsible for determining the appropriateness of any solution that is provided to a patient and may only provide treatment which he or she believes is appropriate to meet the needs of the patient. The primary consideration should always be in best interests of the patient. At no time is an optician required or expected to fill a prescription unless he or she has decided it is in the best interests of the patient to do so.

Can an optician dispense eyewear based on an ophthalmic prescription that was issued in Canada outside of Ontario or in another country?

Yes. Prescriptions that originate within Canada or outside of Canada are acceptable provided that the prescription conforms to the criteria set out in the College of Opticians of Ontario’s Professional Standards of Practice.

Please click here to review the College’s Professional Standards of Practice, Standard 3, for more information regarding the requirements of an acceptable ophthalmic prescription.

Can a sales associate, who is not a licensed health care professional, replace nose pads or missing screws in a patient’s eyeglass frame?

Yes. Non-licensed individuals (i.e. sales associates) may assist the optician with minor repairs to eyeglasses, such as the replacement of screws or nose pads, provided that the optician has inspected the repair prior to returning the eyewear to the patient. The ultimate responsibility for the repair rests with the optician.

Where can I get more information for patients about the importance of visiting a Licensed, Registered Optician?

The College of Opticians of Ontario supports the National Public Awareness Initiative of the Opticians Council of Canada. Opticians can direct their patients to www.LicensedOptician.ca to learn more about the importance of choosing a Licensed Optician for their vision care needs. Opticians can also sign up to obtain access to educational and awareness tools, to learn how to incorporate these tools into their practice and to obtain information about how they can get involved with the National Public Awareness Initiative. 


Privacy and Confidentiality

My employer does not keep hardcopies of patient health records and maintains only electronic records. Is this acceptable?

Yes. Electronic health records are acceptable provided that the health records conform to the criteria set out in the College of Opticians of Ontario’s Professional Standards of Practice.

Apart from the patient health record, the optician must also retain a copy of the patient’s prescription for a minimum of (6) years and must make available the original or copy of the prescription, when requested to do so, provided it includes the date of examination, and the name and signature of the prescriber. As such, if the optician is “scanning” a copy of the prescription which can clearly show a prescriber’s signature from a computer database, then a hardcopy (paper record) is not required. However, if the prescription details are simply inputted into a computer, the optician is required to produce proof of validity if it does not show the prescriber’s signature. A computer generated prescription without a prescriber’s signature will not be accepted by the College.

Please click here to review the College’s Professional Standards of Practice, Standard 6, for more information regarding patient health records.

What is a member’s responsibility regarding confidentiality, privacy
and retention of records?

Patient records contain personal health information which relates to the health information collected by a member during the course of the patient/practitioner relationship. Personal health information includes all of the information that is required to be recorded in the patient file as provided in the College’s Professional Standards of Practice, Standard 6 (Records). Personal health information may also include information that is not required to be recorded in the patient file such as insurance information or a patient’s health card number. Members are obliged to collect the least amount of personal health information necessary that is consistent with the purposes for which it was collected. For example, collecting an individual’s Social Insurance Number is usually not necessary.

Members must take appropriate measures to safeguard all personal information, including personal health information, from unauthorized access, disclosure, use or tampering. The nature of those safeguards will vary depending on the sensitivity of the information and the circumstances. Furthermore, members are required to comply with appropriate retention and destruction practices with regards to patient health records. In accordance with the College’s Professional Standards of Practice, records must be maintained in the dispensary for a minimum of (6) years from the date of last entry to ensure that any services provided to a patient can be identified.

For more information regarding confidentiality, privacy and retention of records, please click here to view the Ontario Information and Privacy Commissioner’s Guide to the Personal Health Information Protection Act.

A patient has requested information from their patient health record. Am I obligated to give out the patient’s measurements (i.e. pupillary distance measurement (PD), keratometry readings, etc.) if they make such a request?

Yes. Under the Personal Health Information Protection Act, 2004 (PHIPA), a patient has a right of access to his or her own personal health information and the optician has a corresponding obligation to provide access in accordance with PHIPA. Requesting access to and a copy of their records is a patient’s right. The physical record of a patient’s personal health information belongs to the optician, but the personal health information contained within the record belongs to the patient.

The above answer is a brief introduction to the right of access provided for in PHIPA. Members must read and be familiar with the College’s Access to Personal Health Information Policy and Explanatory Document when responding to a patient’s request to access his or her personal health information. Please click here to reference the Access to Personal Health Information Policy and Explanatory Document.


Workplace Issues

How should members manage professional boundaries?

Each member is responsible for maintaining professional boundaries with his or her patients. Professional boundaries are the limits between where a strictly professional relationship ends and a nonprofessional relationship begins. Non-professional relationships are social relationships, which may be casual, friendly, or romantic.

For example, if member wishes to date a patient, the patient relationship must first be terminated and arrangements should be made for another optician to treat the patient. The member must then wait an acceptable period of time before beginning to date that patient. What constitutes an acceptable length of time is specific to the unique set of circumstances that surround each case. Members are reminded that the College takes a zero tolerance approach to sexual abuse of patients. Under the Regulated Health Professions Act, a member’s certificate of registration may be revoked if he or she engages in sexual activity with a patient, regardless of whether the activity occurred in the course of a consensual relationship, including marriage. Members are strongly encouraged to consult with the College about their obligations prior to commencing a personal relationship with a former patient.

For more information on managing professional boundaries, please click here to view the College’s Sexual Abuse Prevention Guidelines.

What are a member’s mandatory reporting obligations?

As members of one of Ontario’s regulated health Colleges, students, interns and opticians are legally obligated under the Regulated Health Professions Act, 1991 (RHPA) to file a written report if, during the course of practicing opticianry, they have reasonable grounds to suspect that a patient has been sexually abused by a member of either the same or a different regulated health profession. If the member is aware of the name of the member in question, a “mandatory report” must be filed with the Registrar of the College to which the member who is the subject of the report belongs.

Failure to file a mandatory report is an offence under the Regulated Health Professions Act and is punishable by a fine of up to $25,000 for a first offence and up to $50,000 for a second or any subsequent offence. It may also be considered an act of professional misconduct to fail to file a mandatory report.

For more information on mandatory reporting obligations, please click here to view the College’s Policy on Mandatory Reporting of Sexual Abuse.

 

Do you have a practice related question that isn’t addressed here? If so, please email your question to practiceadvice@coptont.org. Professional Practice FAQ’s are updated on a regular basis, so please come back often to see what new questions have been added to the list.

 


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