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OPTOMETRY LAWS OF OKLAHOMA

SUBCHAPTER 5. RULEMAKING AND DECLARATORY RULINGS PART 3

Title 505: 10-5-13. Acts constituting unprofessional conduct.
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      (a) Pursuant to 59 O.S. 1991, Section 585, the Board has authority to reprimand a licensee or to revoke or suspend a license to practice optometry for unprofessional or unethical conduct. The Board also has authority pursuant to this Section to enact rules stating what acts constitute unprofessional or unethical conduct.
      (b) It shall be unprofessional conduct for an Optometrist to:
            1) Administer, dispense and/or prescribe dangerous drugs for purposes other than generally accepted treatment for the relief of ocular abnormalities.
            2) Prescribe controlled dangerous substances to immediate family members.
            3) Prescribe controlled dangerous substances for a period exceeding 7 days of supply and/or reissue refills without sufficient patient examination.
            4) Sell samples of medication.
            5) Indiscriminately or excessively prescribe, dispense or administer controlled dangerous substances.
            6) Prescribe, dispense, or administer controlled dangerous substances in excess of the amount considered good optometric practice or prescribing, dispensing or administering controlled dangerous substances without medical need in accordance with published standards.
            7) Habitually or excessively use any drug which impairs the ability to practice optometry with reasonable skill and safety to the patient.
            8) Disburse or prescribe any controlled dangerous substance for optometric physician's personal use.
            9) Dispense, prescribe or administer controlled dangerous substances without medical need.
            10) Delegate authority to another person for the signing of prescriptions for either controlled dangerous substances or drugs.
            11) Commit fraud or to misrepresent facts in applying for or procuring an optometric license or in connection with applying or procuring periodic reregistration of an optometric license.
            12) Cheat on or attempt to subvert the optometric licensing examinations.
            13) Be convicted of a felony or any offense involving moral turpitude whether or not related to the practice of optometry.
            14) Be guilty of conduct likely to deceive, defraud or harm the public.
            15) Make a false or misleading statement regarding skill or the efficacy or value of the medicine, treatment or remedy in the treatment of any ocular abnormality.
            16) Represent to the patient that an incurable condition, sickness, disease or injury can be cured.
            17) Willfully or negligently violate the confidentiality between an optometric physician and patient to the detriment of a patient except as required by law.
            18) Grossly or repeatedly commit negligence in the practice of optometry.
            19) Be found mentally incompetent by any court of competent jurisdiction; involuntary commitment to a mental institution shall be considered prima facia evidence of inability of any optometrist to practice optometry until such optometrist satisfies the Board of his or her ability to safely practice optometry.
            20) Be physically or mentally unable to practice optometry with reasonable skill and safety.
            21) Practice or commit other behavior that demonstrates an incapacity or incompetence to practice optometry.
            22) Use any false or fraudulent deceptive statement in any document connected with the practice of optometry.
            23) Practice optometry under a false or assumed name.
            24) Aid or abet the practice of optometry by an unlicensed, incompetent or impaired person.
            25) Allow another person or organization to use an optometrist license to practice optometry.
            26) Commit any act of sexual abuse, misconduct, or exploitation related to or unrelated to the licensee's practice of optometry.
            27) Violate any state or federal regulation relating to controlled substances.
            28) Obtain any fee by fraud, deceit or misrepresentation, including fees from Medicare, Medicaid, or insurance.
            29) Have disciplinary action taken by another state or jurisdiction against a licensee to practice optometry based upon acts of conduct by the licensee similar to acts or conduct that would constitute grounds for action as defined by these files, with a certified copy of the record of the action taken by the other state or jurisdiction being conclusive evidence thereof.
            30) Fail to report to the Board any adverse action taken against the optometrist by another licensing jurisdiction (United States or foreign), by any governmental agency, by any law enforcement agency, or conduct that would constitute grounds for action as defined in these rules.
            31) Fail to report to the Board surrender of a license to practice optometry in another state or jurisdiction, or surrender of membership in any medical or professional association or society while under disciplinary investigation by any of those authorities or bodies for acts of conduct similar to acts of conduct that would constitute grounds for actions as defined in these rules.
            32) Improperly manage optometric records.
            33) Fail to furnish the Board, its investigators or representatives, information lawfully requested by the Board, or to fail to comply with an order of the Board.
            34) Fail to cooperate with a lawful investigation conducted by the Board.
            35) Be unable to practice optometry with reasonable skill and safety to patients by reason of age, illness, drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. To enforce this paragraph, the Board, may upon probable cause, request an optometric physician to submit to a mental or physical examination by physicians designated by it. If the optometrist refused to submit to the examination, the Board shall issue an order requiring the optometrist to show cause why he will not submit to the examination and shall schedule a hearing on the order within 30 days after notice is served on the optometrist. The optometrist shall be notified by either service or by certified mail with return receipt requested. At the hearing, the optometrist and his attorney are entitled to present any testimony and other evidence to show why the optometrist should not be required to submit to the examination. After a complete hearing, the Board shall issue an order either requiring the optometrist to submit to the examination or withdrawing the request for examination. The optometric license of the optometrist ordered to submit to examination may be suspended until the results of the examination are received and reviewed by the Board.

505:10-5-14. Release of contact lenses prescription
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      A. Upon request by a patient, who has paid for all professional services rendered in connection with care, the Optometrist shall release to the patient a copy of the prescription for contact lenses. An Optometrist shall comply with any state or federal law or regulation regarding release of contact lens prescriptions.
      B. A contact lens prescription release by an Optometrist upon patient request shall contain the following, to wit:
            1) Date of issue
            2) Name and address of patient
            3) Name, address and signature of the prescribing Optometrist
            4) All parameters required to properly supply the contact lenses, to include brand names and materials types.
            5) A specific date of expiration, not to exceed twelve (12) months.
            6) Any limitation on refills and notification of scheduled follow-up visits.
            7) Explicit statement that it is a contact lens prescription.
            8) Specific notation that any person, firm or corporation that dispenses or sells contact lenses from the prescription should inform the patient in writing that they should return to the prescribing Optometrist to ascertain the accuracy and suitability of the contact lenses and that the prescribing Optometrist shall not be responsible for any damage or injury resulting from negligence of third parties to include but not limited to negligence in packaging, manufacturing, improper care regimen or recommendations (cleaning, disinfection and wetting) or instructions provided by the seller that lead to over-wear of lenses or improper care of lenses which result in damage to lenses or visual system, and that the prescribing doctor shall not be responsible for contact lens damage, eye injury or damage occurring during the time that lenses are provided by another dispenser.
            9) Notice that the contact lens dispenser shall not adapt, substitute or change the contact lens prescription without prior authorization from the prescribing doctor, to include brand names and specific material types, to do so constitutes the practice of Optometry.
            10) A contact lens prescription is deemed to be determined after the refraction, eye health examination, corneal assessment, and diagnostic lens fitting. No Optometric physician will write a contact lens prescription until the above steps have been performed. No Optometric physician will write a contact lens prescription should the said patients eye health be compromised because of contact lenses.
            11) The words "ok for contact lens", "fit with contact lenses" etc. or similar wording do not constitute a contact lens prescription.
            12) Further - all contact lenses used in the determination of a contact lens prescription are considered to be diagnostic lenses and the use of such lenses by anyone other than an optometric physician or medical physician or someone under his or her direct supervision shall constitute the practice of Optometry.
      C. Failure to comply with the provisions of this Section shall be considered unprofessional and unethical conduct.

Title 505:10-5-15. Employment relationships of optometrists, including Professional Entities.
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      Oklahoma law prohibits some employment relationships while permitting others. The Board of Examiners in Optometry recognizes the following employment arrangements to be legal, and undertakes actions as set out herein to facilitate the lawful practice of optometry in Oklahoma. In doing so, the board recognizes, and each licensed optometrist must also recognize, that the provisions of Oklahoma law which impose obligations or prohibitions on the practice of optometry apply to all licensed optometrists, whatever their employment relationships, including practice of optometry as a sole proprietor of an optometric office.
      (1) Pursuant to the Oklahoma Professional Entity Act, 18 O.S. et seq. (The Act), it is lawful for a licensed optometrist to practice optometry or "related professional services" as an employee of a professional entity, as defined by that Act. Pursuant to the Act, licensed optometrists may practice optometry through a professional entity, or they may practice optometry in conjunction with practitioners of certain other healing arts, including but not limited to, medical doctors and doctors of osteopathy, in a professional entity. In order to facilitate the practice of optometry by licensed optometrists in professional entities, the Board shall perform the following functions and impose the following requirements upon its licensees.
            (A) Upon request by a licensed optometrist, and upon receipt of the affidavit and assurances required by subsection A(2) of this Rule, the Board of Examiners shall issue a certificate pursuant to 18 O.S. 804(2) that the licensed optometrist who proposes to become an owner or manager of a professional entity is duly licensed in accordance with the provisions of the Oklahoma Optometry Act, 59 O.S. 581 et seq.
            (B) As a part of any application for a certificate pursuant to 18 O.S. 804(2) as a condition of becoming an owner or manager of a professional entity, a licensed optometrist shall provide a sworn affidavit, in a form acceptable to the Board of Examiners in Optometry, reciting the names and addresses of the prospective owners and managers and containing the following assurances:
                  (i) The applicant optometrist recognizes that the practice of optometry as an owner or manager or a professional entity does not exempt him or her from any obligation or prohibition otherwise imposed by law. The applicant optometrist recognizes that no professional entity may do any act which is prohibited to be done by individual persons licensed to practice optometry (18 O.S. 814). Further, the licensed optometrist recognizes that the authority of the Board of Examiners in Optometry is in no way limited or restricted by virtue of the fact that an optometrist practices as an owner, manager, or employee of a professional entity (18 O.S. 813).
                  (ii) The applicant optometrist promises to abide by all requirements of Oklahoma law regarding optometric practice, and to ensure that all of his or her employees who are licensed optometrists shall also abide by all such requirements of law. The applicant optometrist must report to the Board of Examiners any licensed optometrist who is an employee of the professional entity who violates any provision of Oklahoma law regarding optometric practice.
                  (iii) Any applicant optometrist must assure the Board that he or she understands that practice of optometry through a professional entity does not waive Oklahoma statutory law, or the Board's rules, which prohibit, among other things:
                        (I) acceptance of employment, either directly or indirectly, by a licensed optometrist from an unlicensed optometrist or any person engaged in any profession or business except the lawful practice of optometry through a professional entity (59 O.S. 585) or an employee of a licensed optometrist or medical doctor as permitted in subsection C of this rule
                        (II) entering into any agreement, contract, arrangement, practice or understanding, written or otherwise, with any optical supplier for the referral or patients either to or from such optical supplier (59 O.S. 595);
                        (III) practicing with the appearance of commercialism or association with any nonprofessional person in any manner which might degrade or reduce the quality of visual care received by citizens of this state (59 O.S. 593);
                        (IV) rendering optometric care in any retail, mercantile establishment or providing to the public prescription eyeglasses, prescription lenses, frames or mountings within or on the premises of any retail or mercantile establishment in which the majority of the establishment's income is not derived from the sale of such prescription optical goods and materials (59 O.S. 596);
      (2) It is lawful for a licensed optometrist to practice optometry or to render "related professional services" through a professional entity as an employee as well as an owner or manager of the professional entity. Such employment does not relieve a licensed optometrist of any duty or prohibition otherwise imposed by law, including, but not limited to those listed in this rule as applicable to owners and managers, and the obligation of registering his or her office location with the Board (59 O.S. 583), and proper display of his or her certificate of registration (59 O.S. 586).
      (3) Further, Pursuant to 59 O.S. 944 it is not prohibited for a licensed optometrist to maintain a professional association with either another licensed optometrist or with a medical doctor, licensed pursuant to Chapter 11 of Title 59 of the Oklahoma statutes. The Board interprets 59 O.S. 944 to authorize a licensed optometrist to enter into a partnership with other optometrists or with medical doctors for the purpose of practicing optometry. Further, the Board interprets 59 O.S. 944 to authorize a licensed optometrist to be directly employed by either another licensed optometrist (or optometrists) or by a medical doctor (or medical doctors). Such partnership or employment in no way relieves any licensed optometrist of any obligation or prohibition otherwise imposed by law.

Title 505: 10-5-16. Therapeutic Pharmaceutical Agent certificate required after June 30, 2006
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      The Board recognizes that the widespread use by optometrists of therapeutic pharmaceutical agents, as authorized by law and under the regulation of the Board, has provided profound benefits for the ocular health of Oklahoma citizens who are patients of doctors of optmetry. The Board further recognizes that only a small number of licensed optometrists in Oklahoma have not been certified to administer therapeutic pharmaceutical agents and that patients of those doctors may find themselves at a disadvantage because they cannot obtain full range of treatment necessary to guarantee their visual welfare. Therefore, the Board shall not renew the license of any optometrist to practice after June 30, 2006 unless that optometrist has completed the necessary education and secured from the Board a certificate to administer therapeutic pharmaceutical agents.

Title 505: 10-5-17. Proper scope of practice of nonlaser surgical procedures
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      (a) The practice of optometry is defined to be the science and art of examining the human eye and measurement of the powers of vision by the employment of any means, including the use or furnishing of any self-testing device, the use of any computerized or automatic refracting device, the use of pharmaceutical agents, the diagnosis of conditions of the human eye, and the correcting and relief of ocular abnormalities by means including but not limited to prescribing and adaptation of lenses, contact lenses, spectacles, eyeglasses, prisms and the employment of vision therapy or orthoptics for the aid thereof, low vision rehabilitation, laser surgery procedures, excluding retina, laser in-situ keratomileusis (LASIK), and cosmetic lid surgery. (59 O.S. § 581) In addition, the practice of optometry shall include the correction and relief of ocular abnormalities by Non-Laser Surgical procedures not excluded in paragraph (b) of this rule.
      (b) Except for the Post Operative Care of these procedures, the following Non-Laser Surgeries are excluded from the scope of practice of optometry:
            (1) Non-Laser Surgery related to removal of the eye on a living human being;
            (2) Non-Laser Surgery requiring full thickness incision or excision of the cornea or sclera other than Paracentesis in an emergency situation requiring immediate reduction of the pressure inside the eye;
            (3) Penetrating Keratoplasty (Corneal Transplant), or Lamellar Keratoplasty;
            (4) Non-Laser Surgery requiring incision of the Iris and Ciliary body, also includes Iris diathermy or cyrotherapy;
            (5) Non-Laser Surgery requiring incision of the Viteous;
            (6) Non-Laser Surgery requiring incision of the Retina;
            (7) Non-Laser Surgical Extraction of the Crystalline Lens;
            (8) Non-Laser Surgery Intraocular Implants;
            (9) Incisional or excisional Non-Laser Surgery of the Extraocular Muscles;
            (10) Non-Laser Surgery of the eyelid for incisional Cosmetic or Mechanical repair of Blepharochalasis, ptosis, and tarsorrhaphy or eyelid malignancies;
            (11) Non-Laser surgery of the boney Orbit, including Orbial Implants;
            (12) Incisional or excisional Non-Laser surgery of the Lacrimal System other than Lacrimal probing or related procedures;
            (13) Non-Laser Surgery requiring full thickness Conjuntivoplasty with graft or flap; and
            (14) Any Non-Laser Surgical procedure that does not provide for the correction and relief of ocular abnormalities.
      (c) the language of the Oklahoma Statutes shall be controlling if there is any conflict between this rule and the statutes.

Title 505:10-7-1 Notification of action on License
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      In accordance with statute, no optometrist's license will be revoked, suspended, annulled, withdrawn or its renewal refused until the licensee is notified by certified mail or by other means of notification as specified in individual proceedings of the facts which warrant the intended action by the Board, and the licensee is given an opportunity to show compliance with all lawful requirements for the retention of the license.

Title 505:10-7-2 Complaints against licensees
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      Charges against Optometrists must be made in the form of a Complaint filed with the Executive Director. If the complaint is unable to be reconciled, then a formal or informal hearing will be set and the Executive Director will advise the members of the Board of the filing of the same, whereupon the time and place of hearing the Complainant will be set. Notice of the time and place of hearing will be given to the Optometrists complained against, and to the Complainant, by the Executive Director by mail at least ten (10) days before the date of the hearing. The proceedings will be conducted in accordance with the Oklahoma Administrative Procedures Act, 75 O.S. 1971 Sections 301 - 327.

Title 505:10-7-3 Renewal after revocation
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      a) Renewal after revocation for failure to pay fees. The Board shall have discretion to issue a new certificate of registration to any of its licensees whose certificate has been revoked for failure to pay the annual license fee. The Board may, at its discretion, issue a new certificate upon payment all annual license fees then due and owing for all years since the revocation of the certificate plus payment of a reinstatement fee of three times annual fee. Prior to issuance of such a new certificate, the Board may, in its discretion, require the applicant to establish his knowledge of Optometry by passing such examinations, including as the Board may deem appropriate, all or part of either state or national board examinations. The applicant may also be required to furnish proof, acceptable to the Board, of good moral character during the period of revocation, and that the applicant has not been convicted of any felony offense at any time.
      b) Renewal of certificates in circumstances of possible misconduct by licensee. If information comes to the Board's attention that the applicant for issuance of a new license after revocation may have engaged in conduct either before or during the period of revocation which, had the applicant been a current licensee, might have resulted in discipline by the Board, the Board may, prior to issuing a new certificate of registration, conduct a hearing to determine if misconduct has occurred which should result in the denial of a new certificate of registration. The Board may decline to issue a new certificate of authority for any misconduct which could result in the suspension or revocation of a certificate under applicable statutes or rules of the Board. Any such hearing shall be conducted with the same notice and procedures employed in keeping the Optometry statutes, the Board's rules and the Administrative Procedures Act. If at the conclusion of the hearing, the Board determines by clear and convincing evidence that applicable statutes or rules have been violated and that a new certificate of registration should not be issued, it will so hold in a written order.

Title 505:10-7-4 Placement of license on inactive status and restoration to active status of such licenses.
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      a) Licensee's request to put license on inactive status. A licensee of the Board may submit to the Board a written request to have his or her license placed upon inactive status under either of the following circumstances:
            1) Permanent retirement from the practice of optometry; or
            2) Temporary withdrawal from the practice of optometry.
While a license is in inactive status, the licensee is not required to pay fees to the Board or attend and report continuing education courses as required by 59 O.S. § 604, but the licensee may do so if desired. During such time as his or her license is in inactive status, the licensee shall not engage in any practice of optometry until the license is restored to active status. A request to place a license in inactive status shall not preclude the Board from taking any disciplinary action against the licensee which the Board may deem necessary and appropriate.
      b) Prohibition on practice of optometry while license is in inactive status. Any licensee of the Board placing his or her license in inactive status shall not engage in any act within the definition of the practice of optometry under the Oklahoma Optometry Act or the rules and regulations of the Board until such time as the license shall be restored to active status. Any act within the definition of optometry performed while a licensee's license is in inactive status shall be considered the unlicensed practice of optometry and shall be subject to all punishments and sanctions available under the laws of the State of Oklahoma and the rules of the Board.
      c) Restoration of license to active status. A licensee who has placed his or her license in inactive status may apply to the Board to have the license restored to active status. All such applications shall meet the following requirements:
            1) The licensee shall be required to provide proof of attendance at and successful completion of educational programs or clinics in a total amount equivalent to the continuing education required by 59 O.S. § 604 and the rules of the Board for all calendar years or partial calendar years during which the license was in inactive status. Any partial year in inactive status shall be counted as a full year, but the licensee shall receive credit for any approved education successfully completed in the partial year before placing his or her license in inactive status. The Board, in its sound discretion, shall determine whether the submitted education is satisfactory and equivalent to that required by 59 O.S. § 604 and the rules of the Board.
            2) The Licensee shall pay all annual fees which came due during the period the license was on inactive status, including a late reinstatement fee not to exceed three times the annual renewal fee.
            3) If the Board has reason to believe the licensee has been guilty of any misconduct which might have resulted in discipline by the Board either before or during the period the licensee's license has been on inactive status, the Board may, prior to restoring the license to active status conduct a hearing to determine if the licensee has violated any law of the State of Oklahoma or Board Rule which should result in discipline by the Board. The Board may decline to restore a license to active status for any misconduct which could result in the suspension or revocation of a certificate under applicable statutes or rules of the Board. The licensee shall also comply with all requirements of Rule 505:10-7-3, governing renewal of certificates after revocation, as may be required by the Board.
Upon satisfaction of the foregoing requirements, the Board may, in its sound discretion, restore the licensee's license to active status and shall communicate its decision to the licensee promptly following consideration at a regular meeting of the Board.

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