Introduction

Opticians in Alberta are regulated health professionals under the Health Professions Act (HPA), and must be registered with the Alberta College and Association of Opticians (ACAO) in order to provide services to the public.  All registrants of the ACAO shall meet competency based educational requirements and pass practical examinations related to dispensing.  Registration also requires that opticians keep their knowledge and skill current through continuing competency development under the quality assurance program.

Opticians may work independently, and/or as part of an inter-professional team to provide assistive, safe and ethical services to the public. As the working environments for opticians are varied, the application of the Standards will depend on the type of practice the optician is working in.  The Standards of Practice for Alberta Opticians should be used in conjunction with the Code of Ethics, Regulations, Bylaws, and the Health Professions Act to offer the best possible eye health services to the public in Alberta.

The HPA

As per section 133 of the HPA, the ACAO is responsible for the development, establishment and maintenance of standards for the practice of opticianry in Alberta to assure the quality of practice of the profession. Opticians are expected to know, understand and comply with these standards.

As per the HPA, some of the activities opticians do in their everyday practice include;

  • Design, supply, prepare, adjust and dispense optical appliances and prostheses, including corrective lenses based on an optical prescription
  • Promote eye health and the correct use of optical appliances
  • Perform refractions and identify the need for corrective lenses
  • Conduct assessments and make referrals where appropriate

Standards are the minimum requirements for the profession and are designed to;

  • Provide guidance and performance expectations for how opticians will conduct themselves in their practice
  • Act as a reference for the public and the profession for the expectation of quality of care
  • Act as a reference to benchmark opticians conduct during the review of professional conduct issues

The purpose of the layout chosen for these standards is to provide guidelines without being so detailed as to be restrictive in the opticians’ application of professional judgement and critical thinking.   Standards need to be reviewed and revised on a regular basis due to changes in technology and professional regulations.   For each Standard listed, there is a basic statement of principle, followed by a more detailed application to provide a clearer understanding or best practices for the profession.

These guidelines are to be used by the members of the ACAO as a reference to specific ACAO Standards of Practice. 

Standard 1 : Professionalism

Compliance with Legislation

This includes, but is not limited to:

a) The Health Professions Act – regulates 29 health professions in Alberta. The majority of these health professions are regulated by self-governing colleges under the Health Professions Act (HPA).  The HPA requires that colleges carry out governance responsibilities in a manner that protects and serves the public interest by:

  • Setting entry requirements (including required education, practical training, and examinations);
  • Identifying services provided by regulated members, setting standards for professional practice;
  • Setting continuing competency requirements; and
  • Investigating complaints about regulated members and imposing disciplinary actions if required.

The optician specific portion for the practice statement and restricted titles may be found under schedule 16.

b) The Health Information Act – The Health Information Act (HIA) sets out the rules for the collection, use, disclosure and protection of health information that is in the custody or under the control of a custodian. Opticians are considered custodians of health information in Alberta.

c) The Personal Information Protection Act – The Personal Information Protection Act (PIPA) is Alberta’s private sector privacy law.  It applies to provincial private sector organizations, businesses and, in some instances, to non-profit organizations for the protection of personal information and to provide a right of access to an individual’s own personal information.

d) Government Organization Act – Restricted activities are high risk activities performed as part of providing a health service that requires specific competencies and skills to be carried out safely. Restricted activities are not linked to any particular health profession and a number of regulated health practitioners may perform a particular restricted activity.

Restricted activities are set out in Schedule 7.1 of the Government Organization Act.

e) ACAO Code of Ethics – Established to provide ethical guidance to Alberta opticians.

f) ACAO Standards of Practice (this document).

g) Opticians Profession Regulation – These regulations cover such things as:

  • Registration categories
  • Restricted activities
  • Titles
  • Practice permits
  • Continuing competency
  • Reinstatement

h) Alberta Human Rights Act – The purpose of the Alberta Human Rights Act is to ensure that all Albertans are offered an equal opportunity to earn a living, find a place to live and enjoy services customarily available to the public without discrimination.

Collaboration with Colleagues

There are currently no guidelines for standard 1.2.

Collaboration with Colleagues

The information that pertains to the release of health information may be found in the Health Information Act (HIA).  The HIA, Section 35 notes that custodians (opticians) may release health information without the consent of the patient for a number of reasons.  One such reason noted is to a person who is responsible for providing continuing treatment and care to the individual.

If another health care professional requests information on a patient that may assist the health professional with providing continuing treatment or care, the optician may release that information without the consent of the patient.   Requirements for documenting this release of information may be found in standard 4, which addresses record keeping.

Collaboration with Colleagues

There are currently no guidelines for Standard 1.4.

Collaboration with Colleagues

There are currently no guidelines for Standard 1.5.

Working Within Scope of Practice

There are currently no guidelines for Standard 1.6.

Working Within Scope of Practice

Unauthorized practice includes:

  • Unregulated professionals performing restricted activities.
  • Regulated professionals working outside their competence.

Professional Identification

Refer to the Opticians Profession Regulation for more information on protected titles.

Professional Identification

There are currently no guidelines for Standard 1.9.

Professional Identification

There are currently no guidelines for Standard 1.10.

Professional Independence

There are currently no guidelines for Standard 1.11.

Professional Independence

There are currently no guidelines for Standard 1.12.

Professional Independence

This information may be found in the Government Organization Act, part 7.1 Section 4(4) and directly refers to section 4(1) which states that no person shall perform a restricted activity or a portion of it on or for another person unless:

  1. the person performing it;
    1. is a regulated member as defined in the Health Professions Act, and is authorized to perform it by the regulations under the Health Professions Act,

A person performing a restricted activity, which for opticians in dispensing, must be regulated and in good standing with the ACAO, which means they have the appropriate training for the restricted activity.  No one may force someone to perform a restricted activity unless the conditions noted above have been met, and the optician has the competence to safely perform the restricted activity.

 

Take Responsibility

There are currently no guidelines for Standard 1.14.

Take Responsibility

There are currently no guidelines for Standard 1.15.

Take Responsibility

There are currently no guidelines for Standard 1.16.

Standard 2: Competence

Participation in Quality Assurance Program

Continuing competency is required by section 3(1)(e) of the Health Professions Act.

Participation in Quality Assurance Program

There are currently no guidelines for Standard 2.2.

Participation in Quality Assurance Program

There are currently no guidelines for Standard 2.3.

Working Within Competence Limitations

As an example: If a contact lens practitioner has limited or no experience fitting scleral contact lenses, they should only do so if working in conjunction with another professional who is authorized and has the skills and experience

Referral to an Appropriate Service Provider

There are currently no guidelines for Standard 2.5.

Patients are Entitled to Current Care

There are currently no guidelines for Standard 2.6.

Standard 3: Practice Management

Place of Business Location

There are currently no guidelines for standard 3.1.

Place of Business Location

There are currently no guidelines for standard 3.2.

Safety and Infection Control in the Practice Environment

Read about the Occupational Health and Safety Code.

Safety and Infection Control in the Practice Environment

A safety officer is responsible for detecting unsafe or unhealthy working conditions, and ensures compliance with laws and regulations governing workplace safety.

  • All opticians and staff should know who that person is and how to contact them.
  • Customers have a right to this information and shall be provided with it upon request.
  • The safety officer should know how to access first aid and or CPR.

Safety and Infection Control in the Practice Environment

This standard refers to opticians following routine precautions at all times, such as hand washing and appropriate waste disposal.  Protocols should be put into place to outline frequency and specific responsibility for cleaning and disinfection of the dispensing facility and instruments.

Additional resources and information for ACAO members regarding safety and infections control:

  1. You can find Health Canada information regarding infection control on their website at:
  1. Infection prevention and control resources for health care professionals on the Alberta Health website at:
  1. Other information from the ACAO website includes:

Safety and Infection Control in the Practice Environment

There are currently no guidelines for standard 3.6.

Privacy

There are currently no guidelines for standard 3.7.

Privacy

There are currently no guidelines for Standard 3.8.

Privacy

A privacy officer means a person designated by an organization to routinely handle health information, and to develop, implement, and oversee the organization’s compliance with legislation such as that noted in the Health Information Act

  • All staff should know who that person is and how to contact them
  • Customers have a right to this information and shall be provided with it upon request

Owning and Operating a Dispensing Facility

A regulated professional includes an optician, optometrist or ophthalmologist

For the purposes of this document, “dispense” – as defined in Schedule 7.1 of the Health Services Restricted Activities – is the objective verification of corrective lenses to the prescription which means to:

  • Counsel the patient before, during and after the purchase process on the suitability of the frame, lens and contact lens selection to their prescription and their needs.
  • Perform measurements for the ophthalmic appliances.
  • Analyze the accuracy of the finished product to the tolerance charts and the patient’s requirements.
  • Manipulate the position of the lenses of a subnormal vision device to ensure appropriate lens positioning for the patient.
  • Alter the powers of a lens within defensible limitations.
  • Alter the fit of a contact lens to fulfill the optical and physical needs of the patient.

Dispensing Requirements

There are currently no guidelines for Standard 3.11.

Supervision of Students and Other Unregulated Staff

This means that:

  • A supervisor of a student takes full responsibility for all duties performed by that student.
  • A supervisor taking on a student is required to train them to the best of their ability.
  • A supervisor may sign off only those tasks that are completed to the level outlined in the practicum agreement.
  • A supervisor must declare completion of supervision should the student no longer be under that supervision.

Supervision of Students and Other Unregulated Staff

This may include, but is not limited to activities such as:

  • answering phones and booking appointments,
  • assisting a patient in choosing a frame,
  • handing out product put aside for a patient by a licensed person,
  • selling non-prescription sunglasses, ready-made readers, or other products such as contact lens solutions and lens cleaners or accessories,
  • performing financial transactions or accounting.

A “regulated professional” is an optician, optometrist, or ophthalmologist.

Third Party Agreements and Billing

Any differences between the posted prices and the amounts covered by a third party contract are to be accepted by the patient prior to the provision of any service related to the dispensing of an optical device.

Third Party Agreements and Billing

There are currently no guidelines for Standard 3.15.

Third Party Agreements and Billing

There are currently no guidelines for Standard 3.16.

Third Party Agreements and Billing

This means that you may not just do the lucrative jobs and refuse those that will cost you money.  As an example, you could not decide to only do single vision jobs under the Alberta Human Services Contract, but not to accept those patients who require multi focal lenses.

Third Party Agreements and Billing

Examples of what ethical billing would include are:

  • signing forms only for the person(s) named in the policy,
  • only billing for product that has been dispensed to the patient, and that meets the contract requirements,
  • filing only for the amount billed for eyeglasses or contact lenses received,
  • dating forms for the correct date of service,
  • informing the insurance company of product returned for credit.

 

Equipment Requirements

The minimum requirements for equipment for various services are as follows:

Dispensing of Eyeglasses            

  • Lensmeter or other device for measuring the power of a lens
  • Device for measuring the pupillary distance of a patient (pupilometer or pd ruler and penlight)
  • Device for measuring the segment or fitting cross height for multifocal lenses
  • Lens gauge/clock
  • PD ruler
  • Thickness calipers
  • Tool to measure vertex distance
  • Adjustment and bench tools
  • Frame heater
  • Visual acuity charts as needed
  • Tolerance charts
  • Frame and lens cleaning products
  • Other as required for level of services being offered

 

Contact Lens Fitting

  • An instrument for measuring corneal curvature (keratometer/ophthalmometer)
  • Slit lamp bio microscope
  • Lensmeter
  • Access to diagnostic trial contact lenses suitable to the type of area of contact lens practice
  • Disinfection equipment/solution
  • Appropriate solutions, currently dated, for caring for contact lenses
  • Distance and near visual acuity charts
  • Sodium fluorescein

If fitting rigid contact lenses the practice must also have:

  • Radiuscope or other tool to measure base curve
  • Means to assess surface and edges of rigid lenses
  • Trial lenses, or access to trial lenses for rigid lens fitting
  • Other as required for level of services being offered

 

Low Vision Assessment

  • near diagnostic magnification aids
  • distance diagnostic magnification aids
  • Distance and near low vision charts
  • Other as required for level of services being offered

The standard magnification powers to determine the patients near needs are 2X, 4X and 6X.

For distance, patients usually require assistance with an intermediate distance, TV distance and infinity distance.

Equipment Requirements

There are currently no guidelines for Standard 3.20.

Standard 4: Record Keeping

Content of Records

Read these charts to find information on patient records.

Patient Records – Eyeglasses

Element of the record Recorded information Form of the record
1.    Required patient demographics

 

Patient demographic requirement

  1. Patient’s name, address and telephone number if available
  2. Patient identifier (example: date of birth but could be something else to verify patient identity)
  3. Other information as required
Electronic or written
2.    Required prescription details Prescription requirements

  1. The name of the lawful prescriber
  2. The patient’s name
  3. The patient’s complete prescription
  4. The date of the examination
Electronic or written
3.    Required record details for dispensing of all optical devices Minimum record requirements for all optical devices

  1. Prescription details (as noted above)
  2. Prescription duplication information (if applicable)
  3. Date each transaction performed
  4. Identifier for the licensed optician who performed the fitting and dispensing of the optical device
  5. Identifier for the licensed optician who is responsible for fitting and dispensing if a student has been involved
  6. Identifier for the licensed optician who performs follow up as needed
  7. Record of release of information to the patient or another practitioner
    • Date, reason, who released to, authorization if any
  8. Record of payment including third party billing

 

Electronic or written
4.    Additional best practices for eyeglass records Additional records which are best practices specific for dispensing eyeglasses

(in addition to the minimum requirements noted in element 3.)

  1. Appropriate measurements for the eyeglasses such as, but not limited to:
    • Optical center placement horizontally and vertically
    • Placement of bifocal/multifocal height
    • Base curvature of lens
    • Vertex distance
  2. Frame specifications including manufacturer, model, size, color
  3. Lens specifications including type of lens, brand and safety information if applicable
  4. All coatings or lens treatments
  5. Specific instructions given to the patient regarding the use, care, or follow up
  6. Record of follow up visits addressing visual problems or refitting as needed
  7.  Identifier for the licensed optician who performed follow up, or who is responsible if a student was involved in the follow up
Electronic or written

Patient Records – Contact Lenses

Element of the record Recorded information Form of the record
5.   Required patient demographics Patient demographics

  1. Patient’s name, address and telephone number if available
  2. Patient identifier (example: date of birth but could be something else to verify patient identity
  3. Other information as required
Electronic or written
6.    Required prescription details Prescription requirements

  1. The name of the lawful prescriber
  2. The patient’s name
  3. The patient’s complete prescription
  4. The date of the examination
Electronic or written
7.    Required record details for dispensing of all optical devices Minimum record requirements for all optical devices

  1. Prescription details (as noted above)
  2. Prescription duplication information (if applicable)
  3. Date each transaction performed
  4. Identifier for the licensed optician who performed the fitting and dispensing of the optical device
  5. Identifier for the licensed optician who is responsible for fitting and dispensing if a student has been involved
  6. Identifier for the licensed optician who performs any follow up
  7. Record of release of information to the patient or another practitioner
    • Date, reason, who released to, authorization if any
  8. Record of payment including third party billing
Electronic or written
8.   Additional best practices for contact lens records Additional records which are best practices for dispensing contact lenses

(in addition to the minimum requirements noted in element 3.)

  1. Patient ocular,  health and family history
  2. Visual acuity
  3. Keratometer/ophthalmometer readings
  4. Observations from a slit lamp/biomicroscope evaluation including pathological or physiological anomalies
  5. Other measurements, observations or information specific to the type of lens being fit such as;
    • Bifocal/multifocal heights
    • Tear quality (TBUT)
    • Pupil size
    • Fissure size
    • Horizontal visible iris diameter
  6. All diagnostic contact lens specification including base curve, diameter, power, lens type (manufacturer and color if applicable)
  7. Assessment of diagnostic lens including;
    • Diagnostic lens appearance and movement
    • Comfort with lens on the eye
    • Monocular and binocular visual acuity
    • Any changes being made to initial diagnostic lens
  8. Instructions and recommendations pertaining to;
    • Insertion and removal
    • Lens care
    • Solution use
    • Replacement schedule and wear time
    • Normal and abnormal adaptive symptoms
    • Contraindications to lens use
    • How and when to access emergency care
  9. Expected date of follow up

Any other evaluations performed and all recommendations provided to the patient

Electronic or written
9.    Additional best practices for contact lens follow up visits Additional records which are best practices for contact lens follow up

  1. Note any changes to patient history
  2. Note changes in eye health
  3. Note any recommendations regarding the time elapsed since the patient last met with an eye care professional in person
  4. Assess;
    • Lens appearance, fit and movement
    • Wearing time
    • Comfort with lenses in place
    • Corneal clarity and integrity
    • Comparison of corneal curvature
    • Conjunctival and lid appearance
    • Tear characteristics
    • Visual acuity
    • Compliance with recommendation on lens handling, lens care, and replacement
  5. Provide and implement a management plan for any problems identified and for future care
  6. Note any other factors or discussions relevant to the continued use of contact lenses by the patient
  7. Note any changes made to lens type, manufacturer, fitting specifications, power or other information as required depending on type of lens
  8. Identifier for the licensed optician who performed follow up, or who is responsible if a student  was involved in the follow up
Electronic or written

Patient Records – Low Vision Devices

Element of the record

Required information Form of the record
10.    Required patient demographics Patient demographics

  1. Patient’s name, address and telephone number if available
  2. Patient identifier (example: date of birth but could be something else to verify patient identity
  3. Other information as required
Electronic or written
11.    Required prescription details Prescription requirements

  1. The name of the lawful prescriber
  2. The patient’s name
  3. The patient’s complete prescription
  4. The date of the examination
Electronic or written
12.    Required record details for dispensing of all optical devices Minimum record requirements for all optical devices

  1. Prescription details (as noted above)
  2. Prescription duplication information (if applicable)
  3. Date each transaction performed
  4. Identifier for the licensed optician who performed the fitting and dispensing of the optical device
  5. Identifier for the licensed optician who is responsible for fitting and dispensing if a student has been involved
  6. Identifier for the licensed optician who performs any follow up
  7. Record of release of information to the patient or another practitioner
    • Date, reason, who released to, authorization if any
  8. Record of payment including third party billing
Electronic or written
13.    Additional best practices for low vision device records Additional records which are best practices for low vision devices

(in addition to the minimum requirements noted in element 3.)

  1. A low vision assessment if completed (this may replace a prescription depending on patient)
  2. Appropriate measurements for any custom appliances
  3. Details of any hand held low vision devices such as magnifiers, including;
    • Power
    • Model
    • Manufacturer
  4. Filter specifications if recommended for contrast sensitivity
  5. Discussions related to;
    • Expectations
    • Limitations
    • Customary adaptation period
    • Maintenance requirements
  6. Recommended follow up
  7. Identifier for the licensed optician who performed follow up, or who is responsible if a student  was involved in the follow up
Electronic or written

 

Patient Records – Optician generated refraction and prescription

Element of the record Required information Form of the record
14.    Required patient demographics Patient demographics

  1. Patient’s name, address and telephone number if available
  2. Patient identifier (example: date of birth but could be something else to verify patient identity
  3. Other information as required
Electronic or written
15.    Required prescription details for the patient record Prescription requirements for an optician generated prescription record

  1. The name of the lawful prescriber
  2. The patient’s name
  3. The patient’s complete prescription
  4. The date of the refraction
    • Notation that it is an optician generated refraction and not a complete eye examination

 

Electronic or written
16.    Required details for the written prescription given to the patient Prescription requirements for an optician generated written prescription record for the patient

  1. prescribers name and contact information,
  2. a valid signature and College assigned license number
  3. The patient’s complete prescription – must include sphere power, cylinder power, axis designation and reading addition if appropriate
  4. If restrictions as to the length of time a prescription is valid is recorded,  the reasons for the restriction must be noted on the prescription

 

17.    Additional best practices for optician generated refraction and prescription records Other best practices specific to optician generated refraction and prescriptions  include:

  1. Detailed patient history
  2. Preliminary exam findings
  3. visual acuity values
  4. Results of any other tests performed
  5. Any fees charged for the service provided
  6. Any other instructions or referrals
Electronic or written

 

Contents of Records

There are currently no guidelines for Standard 4.2.

Contents of Records

  • Corrections to paper records may be done by crossing through the text and writing in the correction, the reason for the correction (if necessary) and the date and initials for the person making the correction.
  • For electronic records, corrections may be made by detailing the correction, the reason (if necessary), the date, and identifier for the person making the correction.

Contents of Records

The physical records belong to the optician, but the patient in entitled to any of the information contained within their file, except under very specific circumstances.  If patients ask for their files, the optician would provide a photocopy, but not the original.

Contents of Records

Information shall be disclosed with the written consent of the patient.  There are also some situations in which opticians are allowed to disclose health information without written consent.

Opticians shall disclose personal health information of a patient to another health custodian within the circle of care without the authorization of that patient, for specific health care purposes.  An example could be a request from an optician at another office requesting contact lens specifications for a patient to offer continuing care.

When disclosing information, the optician shall log or note;

  • The name of the person to whom information was disclosed
  • Date
  • Purpose of disclosure
  • Description of information disclosed

 

The Health Information Act Sections 35-45 allows for the disclosure of health information without consent outside of the circle of care in some situations such as;

  • Family members in certain circumstances
  • Individuals or authorized representatives of individuals (parents or other caretakers)
  • persons acting in the best interest of an incompetent individual
  • Health professional bodies, auditors and quality assurance committees
    • Police when investigating a life threatening injury to the individual
    • Disclosures required by other legislation (courts and subpoenas)
    • Any person to avert or minimize danger

Record Retention and Destruction

There are currently no guidelines for Standard 4.6.

Record Retention and Destruction

Section 60(2) of the Health Information Act states that in order to prevent unauthorized access to or disclosure of health information, custodians need to consider proper disposal of records. Opticians should have a systematic plan for handling this. A scheduled and monitored plan will allow custodians to know what information was destroyed and when. An approved process for the destruction of records after a set time shows consistency and that the office has evaluated their policies and procedures related to health information.

Shredding is the best way to dispose of paper and other hard copy media which may contain personal or health information. Opticians need to ensure that the shredding company can offer secure destruction of the material. For computer equipment that houses personal and health information, computer hard drives should be professionally wiped clean prior to being disposed of or sold.

Record Retention and Destruction

There are currently no guidelines for Standard 4.8.

Record Retention when a Practice Closes or the Optician Retires

This means that when a practice closes, it is the optician’s responsibility to ensure that the records or files are securely stored until the files are ten years old.

Record Retention when a Practice Closes or the Optician Retires

This means that if retiring from or quitting a job, and optician shall transfer their records or files to another optician or other successor custodian, such as an optometrist.

Record Retention when a Practice Closes or the Optician Retires

This could be achieved by placing an ad in local newspapers, sending a letter or email, or posting a sign on the door.

Record Retention when a Practice Closes or the Optician Retires

This means that opticians should call, or send written notification to the ACAO so that we know how to help patients if an inquiry or request for access to records is made.

Records in a Collaborative Practice

There are currently no guidelines for Standard 4.13.

Records in a Collaborative Practice

An information sharing agreement (ISA) is recommended as the Health Information Act (HIA) dictates that custodians of health information have an obligation to protect the integrity, confidentiality and accuracy of patient information and to only use or disclose that information under certain conditions and to certain individuals.  Opticians are custodians under the HIA, as are optometrists and ophthalmologists.  When more than 1 custodian is working in a dispensing facility, which is the case with an optician owned facility where an optometrist comes in to provide services, there is a strong likelihood that each custodian will have access to the others records.

In the case of an optician working in an optometrist owned dispensing facility, this would be different.  In this case if the optometrist is the one making money from the sale of all products, and paying the optician a salary, the optician is an affiliate of the optometrist who is the custodian.

Privacy and Security of Record

There are currently no guidelines for Standard 4.15.

Privacy and Security of Records

There are currently no guidelines for Standard 4.16.

Standard 5: Communication

Communication with Patients, Colleagues, Other Professionals and Staff

There are currently no guidelines for Standard 5.1.

Communication with Patients, Colleagues, Other Professionals and Staff

There are currently no guidelines for Standard 5.2.

Communication with Patients, Colleagues, Other Professionals and Staff

There are currently no guidelines for Standard 5.3.

Communication with Patients, Colleagues, Other Professionals and Staff

There are currently no guidelines for Standard 5.4.

Communication with Patients, Colleagues, Other Professionals and Staff

This would apply for opticians working together in a practice with an optometrist, ophthalmologist or other health care professional. It should be identifiable which custodian is responsible for which services. Best practice would have additions on a new sheet of paper.

Marketing and Promotion

This means that marketing and promotion by an optician or on behalf of an optician shall:

  • Act in the best interest of the patient
  • Claim only those skills authorized by the College
  • Be in good taste
  • Accurately represent the value of the product or service being offered
  • Maintain the integrity of the profession
  • Not claim superiority over another optician or health professional

Marketing and Promotion

There are currently no guidelines for Standard 5.7.

Titles

Any title, if it includes the word optician is restricted and may only be used by regulated members of the profession.

The titles which are restricted as noted in the Health Professions Act and the Opticians Profession Regulation include:

  • Optician
  • Ophthalmic dispenser
  • Optical dispenser
  • Contact lens fitter
  • Contact lens practitioner
  • Contact lens dispenser
  • R.O.
  • C.L.P.
  • Provisional optician

An exception would be a student of the profession registered with a recognised training institution could use the above titles with the word student before the ones that are applicable.

Refer to the Health Professions Act  and the Opticians Profession Regulation.

Websites

Guidelines for this standard include but are not limited to:

  • Complies with all applicable standards of practice such as those for marketing and promotion, privacy of personal and health information, records retention and communication
  • Identifies the name and or license number of any optician who interacts with a patient through the website or interface
Standard 6: Dispensing of Optical Devices

The Prescription (RX)

In order for a written prescription to be valid, it must contain the following information;

  • The name/identifier of a lawful prescriber
  • The patient’s name
  • The patient’s prescription
  • The date of examination
  • Or be a duplication of their current glasses

 

If duplicating an existing optical device, it is to be noted on the patient’s record that it was a duplication, and the optician should, using best practices, confirm the suitability of the prescription to the patient. Confirmation can be done by reviewing visual acuity and/or reviewing the frequency of complete eye examinations.

The Prescription (RX)

Opticians shall use their professional judgement, combined with patient history and employer policies when implementing this standard.

 

One such example for guidance on frequency of complete eye examinations is the Canadian Ophthalmological Society evidence-based Clinical Practice Guidelines for periodic eye examination in adults in Canada.

 

RECOMMENDATIONS from the COS Guidelines (please see entire document for details and additional information)

  1. Screening intervals in the asymptomatic low-risk patient

  • Age 19–40 years: at least every 10 years [Consensus]
  • Age 41–55 years: at least every 5 years [Consensus]
  • Age 56–65 years: at least every 3 years [Consensus]
  • Age > 65 years: at least every 2 years [Level 19]

 

  1. Screening in symptomatic patients

Any patient noting changes in visual acuity, visual field, colour vision, or physical changes to the eye should be assessed as soon as possible [Consensus].

 

  1. Screening intervals in high-risk patients

Patients at higher risk of visual impairment (e.g., those with diabetes, cataract, macular degeneration, or glaucoma [and glaucoma suspects], and patients with a family history of these conditions) should be assessed more frequently and thoroughly.

  • Age > 40 years: at least every 3 years [Consensus]
  • Age > 50 years: at least every 2 years [Consensus]
  • Age > 60 years: at least annually [Consensus]

The Prescription (RX)

This would mean that opticians may use their judgement and the prescription should meet the requirements noted in the guideline for standard 6.1.

Procedures for Dispensing or Re-fitting of all Eyeglasses

This means that when dispensing eyeglasses, the optician must be a registered member in good standing and should, using best practices, routinely do the following:

  1. Evaluate every optical prescription and advise patient of suitability of lenses and frames with the knowledge of occupational needs, hobbies and cosmetics;
  2. Evaluate every optical prescription and advise patient of suitability of lenses and frames with knowledge of optics and geometric physics applied to the product purchased;
  3. Advise patient of the consequences of changes in their prescription with regard to expectation for new eyewear purchased;
  4. Analyze changes in prescription with regards to medical complications indicated;
  5. Endeavour to meet the patients’ needs and expectations with regard to safety, aesthetics and price;
  6. Take all required and other appropriate measurements related to eyeglasses and note them accordingly on the patients record as per Standard 4
  7. Provide training and information as needed on use, care, and follow up of optical devices
  8. Provide follow up care including adjustment and advice to make wear easier and maintenance more effective;
  9. Be able to recall or locate applicable information in detail on their patients’ eyeglasses
  10. Recognize anomalies in prescription and wearing success and to refer the patient to a medical practitioner, if required;
  11. Evaluate every pair of eyeglasses to verify the accuracy of the completed product to ensure they are as ordered and within tolerance (ANSI)
  12. In the case of safety eyewear, adhere to appropriate safety standards.
  13. Ensure that the practice environment has appropriate tools and equipment as per Standard 3 of this document
  14. Ensure that patient records are complete as per Standard 4 of this document

Initial Contact Lens Fitting

This means that when an optician is completing an initial contact lens fitting, the optician must be a registered member in good standing on the contact lens register and should, using best practices, routinely do the following:

  1. Take a patient history and determine suitability of the patient for contact lens wear including;
    • The health of the cornea, conjunctiva and lids, and integrity of the tear layer
    • Baseline visual acuity, corneal curvature, clarity and integrity
    • Relevant environmental, occupational, avocational and systemic health factors
  2. Counsel the patient about the effects that contact lens wear may have on the health of the eye including advantages, risks of complications and limitation of contact lens wear
  3. Determine what lenses are appropriate for the patient and evaluate the initial contact lenses on the patient’s eyes. Subsequent modifications of the contact lens parameters shall be made as required based upon factors that may include, but are not limited to:
    • Lens appearance and fitting
    • Comfort with diagnostic lens in place
    • Corneal clarity and integrity
    • Conjunctival and lid appearance
    • Tear characteristics
    • Monocular and binocular visual acuity
    • Replacement schedule
  4. Verify the accuracy of the contact lenses to ensure they are as ordered and within tolerance
  5. Provide and record any relevant details of instructions or recommendations to the patient with respect to:
    • Hygiene
    • Lens insertion and removal
    • Lens care
    • Recommended wearing times and replacement schedules
    • Normal and abnormal adaptive symptoms
    • Contraindications to lens use
    • Progress evaluations
    • How and when to access emergency care
  6. Develop an appropriate ongoing patient management plan. This includes determining when the patient should return for an assessment of lens performance, adaptation and compliance; for contact lens refills or replacement, or for further evaluation
  7. Record the results of all evaluations performed and all recommendations provided to the patient

Contact Lens Assessment or Follow-Up

This means that the optician must be a registered member in good standing on the contact lens register and should, using best practices, routinely do the following:

  1. Review the ongoing patient management plan, considering such factors as:
    • Any changes in the patients eye health or other relevant circumstances
    • Time elapsed since the patient last met with an eye care professional in person
    • Changes to occupation or other needs
  1. Review as appropriate:
    • The age, wearing, and replacement schedule of current contact lenses
    • The efficacy of the current lens care regime
    • Any adverse reactions associated with contact lens wear
  1. Assess the patient to determine relevant factors, such as:
    • Lens appearance and fit
    • Wearing time
    • Comfort with lenses in place
    • Corneal clarity and integrity
    • Stable corneal curvature
    • Conjunctival and lid appearance
    • Tear characteristics
    • Visual acuity
    • Compliance with recommendations on lens handling, care and replacement
  1. Provide and implement management plans for any issues identified, making recommendations for further care and counsel the patient as necessary

Replacement Contact Lenses

See standard 6.5.

There are currently no guidelines for standard 6.7.

Replacement Contact Lenses

This means that the optician must be a registered member in good standing on the contact lens register and should, using best practices, routinely do the following:

  • Ensure the patient’s information is current
  • Determine the need for alterations to previous lens specifications and make adjustments accordingly
  • Advise the patient as to the need for and extent of continuing care
  • Confirm the parameters of contact lenses as ordered
  • Provide follow up services in accordance with the management plan

Verification of Optical Devices at Time of Dispensing

This means that the optician shall verify that:

  • Patients’ needs have been identified and discussed,
  • Vision requirements have been appropriately met,
  • Limitations of optical devices in regards to a patients’ prescription, or visual condition have been discussed
  • Patients understand the necessity of and availability of follow up care
  • Optical devices have been verified for quality, specifications and are within tolerance (ANSI)

Patient records are complete as per Standard 4 of this document.

Low Vision Devices

This means that the optician must be registered member in good standing and should, using best practices, routinely do the following:

  1. Review with the patient any relevant environmental, occupational, avocational, and/or physical factors
  2. Review and referral or prescription details in accordance with these standards of practice
  3. Advise the patient regarding appropriate low vision device(s)
  4. Take necessary measurements
  5. Verify the accuracy of any device to ensure they meet tolerances
  6. Fit and adapt the device to the patient
  7. Counsel the patient on aspects of device usage such as expectations, limitations, customary adaptation period and maintenance requirements

 

 

 

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