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The optometric law page contains links to portions of Oklahoma State Law which are relevant to the practice of optometry in the state of Oklahoma. What follows is a table of contents which is linked to the various sections of the law. The table of contents divides the law into thirteen different pages. Each page is further subdivided into specific sections. To download the entire document as a PDF file click here (181 KB).1. Definition of Optometry, etc.
Existing Board Rules can be found in the law under the "Law" tab. Proposed Board Rules will be listed below.
505:10-5-18 Dispensing Medications by Optometrists Pursuant to 75 O.S. § 250.3(17), this Rule interprets and prescribes law and policy for registered Optometrists licensed by the Board. Effective November 1, 2020, 59 O.S. 581(B) was amended to include in the definition of the practice of optometry the dispensing of drugs and may include the dispensing of professional samples to patients. This new statutory grant of authority to dispense drugs comes with it a duty to comply with a number of pre-existing laws governing dispensing drugs. Foremost among these is the Board rule on unprofessional conduct. It is considered unprofessional conduct to “[v]iolate any state or federal regulation relating to controlled substances.” OAC 505:10-5-13. It is the responsibility of any Oklahoma licensed Optometrist wishing to dispense drugs as part of his or her practice to be fully informed of all the applicable laws pertinent to dispensing and to comply with them. The laws pertinent to dispensing include, but are not limited to, the following.
1. The Uniform Controlled Dangerous Substances Act, 63 O.S. Section 2-101(11) defines “dispense” as follows: "Dispense" means to deliver a controlled dangerous substance to an ultimate user or human research subject by or pursuant to the lawful order of a practitioner, including the prescribing, administering, packaging, labeling or compounding necessary to prepare the substance for such distribution. "Dispenser" is a practitioner who delivers a controlled dangerous substance to an ultimate user or human research subject. (emphasis added). The Board interprets this provision to mean that an Optometrist can only “dispense” a drug for which he or she has lawfully issued a prescription to the patient.
2. The existing scope of practice of Optometrists to prescribe drugs is found in 59 O.S. § 581(B) which states:
The practice of optometry [also includes] the prescribing of dangerous drugs and controlled dangerous substances for all schedules specified in the Uniform Controlled Dangerous Substances Act except Schedules I and II but allowing for the prescribing of hydrocodone or hydrocodone-containing drugs regardless of schedule for a period not exceeding five (5) days of supply, and the issuance of refills for such prescriptions following sufficient physical examination of the patient for the purpose of diagnosis and treatment of ocular abnormalities.
Thus, by statute, Oklahoma licensed Optometrists cannot prescribe Controlled Dangerous Substances from Schedules 1 and 2 except for hydrocodone or hydrocodone-containing drugs and only as authorized above.
3. Pursuant to 63 O.S. §2-302, every person who dispenses drugs will first register with the Director of the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control. Further, 63 O.S. § 309C calls for dispensers of Schedule II, III, IV or V controlled dangerous substances to electronically report certain information to the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control (OBN). Willful failure to transmit the information called for is a misdemeanor. Similar information is called for by OAC 475:45-1-2 (Reporting of certain information called for) for dispensing practitioners filling any Schedule II, III, IV, or V prescriptions who are called for to provide certain information to a central repository maintained by the (OBN) for each prescription dispensed. Any optometric practitioner registering with the Director of the OBNDD will promptly provide a copy to the Board of Examiners in Optometry with the application for registration and will promptly inform the Board of any circumstance and provide all documentation from the OBNDD concerning any disciplinary proceeding by the OBN against the registrant, regardless of its final disposition.
4. In addition, Board Rule OAC 505:10-5-6 (Provision for registering intent to dispense dangerous drugs and controlled dangerous substances) provides that “[a]ny certified licensed practitioner of Optometry desiring to dispense dangerous drugs, pursuant to 59 OS Supp. 1987 Section 355.1 will register such intent with the Oklahoma Board of Examiners in Optometry and meet annual continuing education provisions as set by the Board. Any certified licensed professional Optometrist desiring to dispense controlled dangerous substances will first obtain a registration number from the United States Drug Enforcement Agency.” The pharmacy statute, 59 O.S. § 355.1, also contains substantive duties for licensed practitioners like Optometrists to dispense dangerous drugs.
5. All applicants and registrants will provide effective controls and procedures to guard against theft and diversion of controlled dangerous substances pursuant to OAC 475:20-1-2. (General security provisions).
6. Though 475:20-1-5 (Other security controls for nonpractitioner registrants) by its title appears not to apply to practitioner registrants, in its text certain provisions for practitioner registrants appear and registrants need to be familiar with these.
7. Because hydrocodone is now a Schedule 2 drug, OAC 475:20-1-6 (Physical security controls for practitioners) provides security provisions for its storage.
The foregoing provisions are only some of the presently existing legal provisions for those who dispense drugs. It is the responsibility of the optometric practitioner to inform himself or herself of all applicable provisions, as they presently exist and as they may exist in the future, and to comply with those provisions while dispensing drugs as part of the practice of optometry.
Proposed Rule 505:10-5-19 Telemedicine encounters in the practice of optometry
1. The practice of optometry is defined to be the science and art of examining the human eye and measurement of the powers of vision and measurement of the powers of vision by the employment of any means. This includes asynchronous and synchronous technologies including the use of videoconferencing, internet-based services, store-and-forward imaging, streaming media, and terrestrial and wireless communications. The scope of delivery of care as defined in subsections A and B of 59 OS 581 to an individual who is physically located in this state and any time care is delivered shall constitute the practice of optometry.
2. The prescribing for spectacles or contact lenses by an optometrist requires a comprehensive visual examination conducted by a physician holding a license to practice optometry in this state. A comprehensive visual examination shall be in-person by an eye doctor with a face-to-face encounter. In the absence of an existing doctor patient relationship, a prescription for glasses or contact lenses can only be derived through the completion of a comprehensive eye examination. Board Rule 505:10-5-9 establishes the tests and measurements that require findings on the comprehensive examination of a patient for where an optometrist signs a prescription for ophthalmic lenses or contact lenses. While technology has advanced and continues to advance, in-person care, provided by a doctor of optometry, is the criterion standard for the delivery of a comprehensive eye exam. Direct-to-patient eye and vision-related applications, based on current technologies and uses, cannot replace or replicate a comprehensive eye exam provided by a doctor of optometry. Direct-to-patient eye and vision-related applications may provide data related to elements of a comprehensive eye exam but do not constitute patient care and fragmentation of a comprehensive eye exam into components delivered independently is deleterious and deceptive to patients. Telemedicine encounters in this state shall not be used to establish a valid physician-patient relationship for prescribing contact lenses and or spectacles because it is not on par with the same service delivered in person. The relationship for prescribing shall include a medically appropriate and timely scheduled face to face encounter between the patient and a physician. The prescribing physician must provide the patient with the treating physicians’ identity and professional credentials. Screenings cannot be used to diagnosis or treat conditions. Screenings cannot be used to replace in person comprehensive eye examination. Refractive tests, including online vision tests and other mobile vision related applications, cannot be, based on current technologies and uses, used to provide a refractive diagnosis and/or an eyeglass or contact lens prescription.
3. Telemedicine encounters shall comply with the Health Insurance and Accountability Act 1996 AC 435:10-7-13 and ensure that all patient communication and records are secure and confidential. Doctors may not waive their obligation or require patients to waive their right to receive the standard of care. Payors may not require either doctor or patient waive right to receive the standard of care. The doctor must establish/maintain fundamental elements of the doctor-patient relationship. Board approval of telemedicine: In the event a specific telemedicine program is outside the parameters of these rules, the Board reserves the right to approve or deny these rules, the Board reserves the right to approve or deny the program.
Telemedicine in Optometry Encounters
Physicians treating patients in Oklahoma through telemedicine in optometry must be fully licensed to practice optometry in Oklahoma and must proceed as follows. Physicians cannot establish a doctor-patient relationship via telehealth. During telemedicine encounters, the distant site physician performs an exam of a patient at a separate, remote originating site location which shall be registered with the Board of Examiners in optometry by the distant site physician as a primary or branch practice location. If the distant site physician deems it to be medically necessary, or if Oklahoma law requires manual procedures at the near site in order to meet legal definitions of procedures which meets the standard of care, a licensed optometrist in this state trained in the use of the equipment shall be utilized at the originating site to “present” the patient, manage the camera, and perform any physical activities to successfully complete the exam. The optometrist must obtain or review all aspects of the patient’s medical history and any available medical records. A medical record must be kept and be accessible at both the distant and originating sites; preferably a shared Electronic Medical Record, that is full and complete and meets the standards as a valid medical record. There should be provisions for appropriate follow up care equivalent to that available to face-to-face patients and be on par with the same service delivered in person. The information available to the distant site physician for the medical problem to be addressed must be equivalent in scope and quality to what would be obtained with an original or follow-up face-to-face encounter and must meet all applicable standards of care for that medical problem including the documentation of a history, a physical exam, the ordering of any diagnostic tests, making a diagnosis and initiating a treatment plan with appropriate discussion and informed consent. Informed consent for a telemedicine in optometry encounter will include:
1. How physician will respond to electronic messages
2. Using alternate communications means in emergencies
3. Who has access to electronic communications
4. How electronic messages delivered to specific physician
5. How electronic communications are stored
6. When/how physician discontinue providing telehealth services
During a telemedicine in optometry encounter the physician must also do the following:
1. Must verify patient identity
2. Establish a medical history and permanent patient record
3. Must have contact methods other than electronic only – phone, mailing address and physician emergency contact information
4. Assess and document patient is capable of electronic visits
5. Physicians will disclose his/her identity and credentials, including informing the patient that the optometrist is licensed to practice in the jurisdiction in which the patient is located;
6. A photograph (head shot) should be attached the optometrist’s license and displayed prominently in the examination room so that the patient can identify and match the doctor on the telemedicine prompter to the doctor’s license.
7. Place the welfare of the patient first; protect patient confidentiality; maintain acceptable standards of practice; and properly supervise and oversee any technicians participating in the telemedicine process, thus maintaining appropriate control over the practice.
During a telemedicine in optometry, the care standards remain the same for telehealth as in person. On-line refractions do NOT meet acceptable standards of care. Physicians cannot prescribe controlled substances via telehealth. Physicians cannot split fees for care.
. The Board believes that telemedicine is a tool and not a separate field of optometry, nor does telemedicine alter the scope of practice of Oklahoma-licensed optometrists. Accordingly, the Board cautions those subject to its jurisdiction and control that there is no separate or different scope of practice or standard of care applicable to those who practice optometry via telemedicine within this state or to those optometrists located outside Oklahoma who diagnose and treat via telemedicine patients located within this state. A failure to conform to the appropriate standard of care, whether that care is rendered in person or via telemedicine, may subject the licensee to investigation and discipline by the Board.
The optometrist who utilizes telemedicine in Oklahoma should be mindful of certain requirements and challenges inherent in practice via remote means, among them the following:
Examination, evaluation, and diagnosis: the optometrist must conduct an appropriate evaluation prior to diagnosing or treating the patient, including prior to rendering a prescription for pharmaceuticals, spectacles, or contact lenses. Physical remoteness of the patient does not change the need for a proper patient identification, appropriate intake procedures, adequate patient history, examination, and, where indicated, testing. An optometrist is not excused from performing an appropriate examination, evaluation, and assessment of the patient’s condition by virtue of the patient’s physical remoteness from the optometrist. Any technician involved in the telemedicine patient encounter should be trained in the use of all equipment utilized in the telemedicine encounter and competent in the operation of such equipment. Patient records: the optometrist treating via telemedicine must create and maintain a complete record of the patient’s intake, diagnosis, and treatment, no different than for an in-person patient encounter. The optometrist must have access to those records at all times so that the optometrist can address and communicate with the patient about any issue the patient brings to the optometrist’s attention. Maintaining these records electronically so that they can be accessed from any of the optometrist’s practice locations and after normal business hours meets the standard of care. Prescribing: Prior to prescribing any medication or ophthalmic device (such as spectacles, contact lenses, or low vision devices) the optometrist must conduct an appropriate assessment of the ocular health and visual status of the patient. It is the position of this Board that the standard of care does not permit an examination consisting solely of objective refractive data or information generated by an automated testing device such as an autorefractor in order to establish a medical diagnosis or to establish refractive error. Likewise, issuing a prescription based solely on a patient’s responses to a written or online questionnaire does not meet the standard of care in Oklahoma. Where the practice of optometry occurs: The Board considers that the practice of optometry occurs both where the patient is located and where the optometrist providing professional services is located. In order for an optometrist to provide professional optometric services to a person located in Oklahoma that optometrist must be licensed by this Board. Laws and regulations governing the practice of optometry in Oklahoma: As indicated previously, there is no separate standard of care for telemedicine in the practice of optometry in Oklahoma. Accordingly, the optometrist who seeks to use telemedicine in his or her practice should be familiar with the requirements of the Oklahoma Board of Optometry subsections A and B of 59 OS 581 and all other applicable laws and regulations, whether state or federal. By way of example, Oklahoma laws and rules require: 1. Board Rule 505:10-5-9 establishes the tests and measurements that require findings on the comprehensive examination of a patient for where an optometrist signs a prescription for ophthalmic lenses or contact lenses. The optometrist should have an established and appropriate procedure for the provision of eye care to his/her patients outside of normal practice hours, and should inform patients sof those procedures
Other licensing bodies may also have oversight: Oklahoma licensees who wish to treat patients located outside Oklahoma by utilizing telemedicine should know both that this Board has oversight of such practice and that other states’ boards of optometry may take the position that such constitutes the practice of optometry in their respective states, and accordingly such boards also may require licensure in their states as a prerequisite. Optometrists intending to practice in such manner should therefore check with the optometry boards in all states in which they intend to treat patients for those states’ licensure requirements to determine whether or not such practice is permitted in those jurisdictions. Displaying license and current certificate of renewal; branch office licenses: Title 505:10-5-7(2). The licensee must display his/her license and current certificate of renewal in a conspicuous place in each of the optometrist’s offices. As noted above, a head shot photograph of the doctor should be attached to the license. A licensee who practices in more than one office location must obtain a duplicate license for each such branch office, with such branch office licenses to be displayed in like manner.
Equipment and technical standards
1. Telemedicine technology must be sufficient to provide the same information to the provider as if the exam has been performed face-to-face.
2. Telemedicine encounters must comply with HIPAA (Health Insurance Portability and Accountability Act of 1996) security measures to ensure that all patient communications and records are secure and remain confidential.
3. Technology guidelines
Audio and video equipment must permit interactive, real-time communications
Technology will be HIPPAA compliant
Unprofessional conduct includes prescribing for treatment without sufficient examination noted in Board Rule 505:10-5-9 , proceeding without the establishment of a valid physician-patient relationship, violations of this telemedicine rule under the authority of 59 O.S. § 585(A). and not prescribing in a safe, medically accepted manner. (b) Applicability and scope. The purpose of this Section is to implement telemedicine policy that increases access to optometric services, while complying with all applicable state and federal laws and regulations. Telemedicine services are not an expansion of the scope of practice of Optometry, but an option for the delivery of certain services within that scope of practice. However, if there are technological difficulties in performing an objective, thorough medical assessment, or problems in the patient's understanding of telemedicine, hands-on-assessment and/or in-person care will be provided for the patient. Any service delivered using telemedicine technology will be appropriate for telemedicine delivery and be of the same quality and otherwise on par with the same service delivered in person. A telemedicine encounter will maintain the confidentiality and security of protected health information in accordance with applicable state and federal law, including, but not limited to, 42 Code of Federal Regulations (CFR) Part 2, 45 CFR Parts 160 and 164, and to the same extent as physician-patient communications, and medical, drug abuse, or mental health records are protected by 43A O.S. § 1-109. For purposes of the scope and practice of optometry, telemedicine is deemed to be “ the use of any computerized or automatic refracting device, including applications designed to be used on a computer or video conferencing via an Internet device either in person or in remote locations,” within the meaning of 59 O.S. § 581(A).
Sections 581 to 598
Section 581. Practice of Optometry - Definition
Section 582. Board of Examiners in Optometry - Continuance - Vacancies - Qualifications - Term of Members.
Section 583. Board of Examiners - Authority to Make Rules and Regulations - Organization - Quorum
Section 584. Qualifications of Applicants - Examination - Registration - Certificates to Practice to Persons from other States.
Section 585. Revocation of Certificate - Grounds - Unprofessional and Unethical Conduct, Definition of - Rules and Regulations - Practice Under Own Name - Notice and Hearing on Revocation - Reissuance of Revoked Certificate.
Section 586. Certificates - Recordation - Exhibition of Certificates.
Section 587. Examinations-Fees-Compensation and Expenses - Optometry Board Revolving Fund.
Section 588. Practice by Unauthorized Person - False Personation - Evidence of Violations - Punishment.
Section 589. Persons Exempted from Statute.
Section 591. Certificates of Registration.
Section 592. Effect of Invalid Sections.
Section 593. Public Policy.
Section 595. Certain Agreements, Contracts, Understandings, etc. Prohibited.
Section 597. Penalties.
Section 598. Provisions Cumulative.
2. Finances - Appointments - Post-Graduate Work
Sections 601 to 646.7
Section 601. Appropriation
Section 602. Expenses for Operation of Board.
Section 603. Appointments and Salaries
Section 604. Attendance on Educational or Postgraduate Program.
Section 605. Provisions of Act Cumulative.
Section 606. Invalidity Clause.
Section 646.1. Definitions.
Section 646.2. Assessment Mechanisms-Duties-Disclosure-Standard of Care
Section 646.3. Prescriptions for Contact Lenses and Visual Aid Glasses-Required Inclusions.
Section 646.4. Prescriptions for Contact Lenses-Expiration Dates.
Section 646.5. Verification of Contact Lens Prescription-Method and Protocol-Limitations.
Section 646.6. Responsibility for Accuracy in Dispensing of CL or Visual Aid Glasses.
Section 646.7. Contact Lens Fitting-Requirements for Completion.
3. Designation of Branch of Healing Art
Sections 725.1 to 725.5
Section 725.1 Use of Word
Section 725.2 Right to Use Word "Doctor" or Abbreviation Thereof
Section 725.3 Violations of Provisions
Section 725.4 Written Disclosure of Financial Interest of Professional or Provider-Penalties
Section 725.5 Civil Liability-Medical Care on Voluntary Basis at Free Medical Clinic or
Educational Sporting Event
4. Unlawful Practice of Healing Arts
Sections 731.1 to 738.4
Section 731.1 Definitions.
Section 731.2 Use of Word "Doctor" or "Dr."
Section 731.3 License or Certificate.
Section 731.4 Violations of Act.
Section 731.5 Application of Law.
Section 736.2 Injunction - County Attorney - Attorney General.
Section 738.1 Injunctions - Granted to Boards.
Section 738.2 Permission From Boards to Institute - When.
Section 738.3 Attorneys, Employment of.
Section 738.4 County Attorney - Act not to Abrogate Right.
5. Optical Goods and Devices - Sale Of
Sections 941 to 947
Section 941. Public Policy.
Section 942. Fitting, Adjusting or Applying Lenses or Other Optical Appliances, Duplicating or Replacing Lenses, Etc. Without License Unlawful.
Section 943.1 Advertisement of Ophthalmic Lenses, Frames, Eyeglasses, Spectacles or Parts.
Section 943.2 Prescriptions for Spectacles or Eyeglasses-Copies
Section 943.3 Standards - Eyeglasses, Spectacles, Lenses or other Optical Devices or Parts.
Section 944. Rebates or Premiums to Optometrists or Physicians Prohibited - Employment for Purposes of Making Eye Examinations or Doing Visual Corrections Prohibited - Exceptions - Retail Stores Prohibited From Renting Space to Persons Purporting to Do Eye Examinations.
Section 945. Discrimination between Licensed Practitioners by State Employees Prohibited - Exception.
Section 946. Violations -Punishment - Injunction - Duties of County Attorney - Act to be Cumulative with Existing Laws.
Section 947. Not to Affect Laws Concerning Chapter 14, Title 59, O.S. 1951.
6. Professional Corporations
36 O.S. 6051 to 56 O.S. 199
36 O.S. 6051 Free Choice of Practitioner and Profession - Equal Reimbursement.
56 O.S. 199. Visual or Optometric Services - Free Choice of Practitioner and Profession.
7. Rules and Regulations of the State Board of Examiners in Optometry
Title 505:1-1-1 to Title 505:1-3-9
Title 505:1-1-1 Purpose
Title 505:1-3-1 General Board Purpose and Method of Operation
Title 505:1-3-2 Powers and Duties of the Board
Title 505:1-3-3 Board Composition and Officers
Title 505:1-3-4 Board Meetings
Title 505:1-3-5 Official Board Records
Title 505:1-3-6 Availability of Records and Manner of Obtaining Information
Title 505:1-3-7 Availability of Board Rules, Regulations, Policy Statements
Title 505:1-3-9 Annual License Fee
8. Subchapter 5. Rulemaking and Declaratory Rulings Part 1
Title 505:1-5-1 to Title 505:10-3-9
Title 505:1-5-1 Opportunity for Hearing
Title 505:1-5-2 Petition for Rulemaking
Title 505:1-5-3 Notice
Title 505:1-5-4 Rulemaking hearing
Title 505:1-5-5 Effective date
Title 505:1-5-6 Emergency Rules
Title 505:1-5-7 Request for declaratory ruling
Title 505:1-7-1 Definitions
Title 505:1-7-2 Filing of papers
Title 505:1-7-3 Initiation of petition for individual proceeding
Title 505:1-7-4 Notice to parties
Title 505:1-7-5 Service of notice
Title 505:1-7-6 Time of hearing; request for extension
Title 505:1-7-7 Conduct of hearing
Title 505:1-7-8 Record of Hearing
Title 505:1-7-9 Findings of fact
Title 505:1-7-10 Notice of facts
Title 505:1-7-11 Final orders, proposed finding of facts and conclusions of law
Title 505:1-7-12 Communication with parties
Title 505:1-7-13 Subpoenas
Title 505:1-7-14 Requests for disqualification
Title 505:1-7-15 Rehearing, reopening or reconsideration
Title 505:1-7-16 Informal hearing of a matter
Title 505:1-7-17 Stipulation of an order
Title 505:10-1-1 Purpose
Title 505:10-1-2 Forms and instructions
Title 505:10-1-3 Sample of official forms
Title 505:10-3-1 Application for license
Title 505:10-3-2 Examination of Candidates
Title 505:10-3-3 License requirements
Title 505:10-3-4 Granting of license
Title 505:10-3-5 Reciprocity abolished
Title 505:10-3-6 Special volunteer licenses
Title 505:10-3-7 Acceptance of Military education, training, and experience toward
qualification for licensure examination.
Title 505:10-3-8 Expediting issuances of license or certificate, or temporary permit.
Title 505:10-3-9 Automatic extension of licenses for those deployed on active duty
with the Armed Forces.
9. Subchapter 5. Rulemaking and Declaratory Rulings Part 2
Title 505:10-5-1 to Title 505:10-5-12
Title 505:10-5-1 Minimum standard of sanitation, hygiene and professional surroundings
Title 505:10-5-2 Prohibition against practicing in proximity to retail optical outlet
Title 505:10-5-3 Prohibition against solicitation
Title 505:10-5-4 Prohibition against practicing in connection with commercial business
Title 505:10-5-5 Prohibition against practicing under name other than proper name
Title 505:10-5-6 Requirement of registering intent to dispense dangerous drugs and controlled dangerous substances
Title 505: 10-5-7 Practice in two locations
Title 505:10-5-8 Penalties for practicing without renewal certificate
Title 505:10-5-9 Required findings on examination of patient
Title 505:10-5-10 Prohibition against false advertising
Title 505:10-5-11 Authorized post-graduate educational work
Title 505:10-5-12 Code of Ethics
10. Subchapter 5. Rulemaking and Declaratory Rulings Part 3
Title 505:10-5-13 to Title 10-7-4
Title 505:10-5-13 Acts constituting unprofessional conduct
Title 505:10-5-14 Release of contact lenses prescription
Title 505:10-5-15 Employment relationships of optometrists, including Professional Entities
Title 505:10-5-16 Therapeutic Pharmaceutical Agent certificate required after June 30, 2006
Title 505:10-5-17 Proper scope of practice of nonlaser surgical procedures
Title 505:10-7-1 Notification of action on License
Title 505:10-7-2 Complaints against licensees
Title 505:10-7-3 Renewal after revocation
Title 505:10-7-4 Placement of license on inactive status and restoration to active status of such licenses