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Optometry Investigators

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Tyoical rules on equipment required for Optometric Exams

Optometry Investigators

  1. 1. Optometry Chapter 463 Rules 64B13 Investigational Managers Meeting August 30, 2006 Fort Lauderdale, FL Robert M. Easton, Jr., O.D., F.A.A.O. Optometric Physician Member, Florida Board of Optometry
  2. 2. What constitutes a complete examination of the eye? CPT Procedure Codes, Laws, and Rules  92004 New Patient  92014 Established Patient  463.005(c) Minimum procedures which shall constitute a visual examination.  64B13-3.007 (2) (a-l) Minimum Procedures for Vision Analysis
  3. 3. Optometry’s Required Eye Exam  Patient History; medical and ocular, includes patient’s chief complaint  Family History; medical and ocular  Visual Acuity; unaided and aided in each eye  External Examination  Pupillary Examination must document size, direct and consensual response  Visual Field by confrontation using finger counting in each quadrant  Ophthalmoscopy, internal examination; recording c/d ratio, a/v ratio, and any other abnormalities. A dilated exam is required on all New Patients  Biomicroscopy or Slit Lamp Examination of lids, lashes, conj, cornea, a/c, iris, lens. Corneal Iris Angle assessment of narrow or wide  Tonometry or pressure of each eye with the time it was taken  Refraction for distance with acuities, and near refraction assessment of accommodation with acuities  Extra ocular muscle balance assessment by cover test, phorias, stereopsis, versions  Other tests indicated based upon the patient history or by objective signs and symptoms discovered during the eye exam  Diagnosis which can be cross referenced to a ICD-9 code  Treatment Plan such as correction, medications, referral, and when to return
  4. 4. What Equipment must an Optometrist have to perform a complete examination?  463.005 (b) Minimum equipment which a licensed practitioner shall at all times possess to engage in the practice of optometry.  64B13-3.004 (1-8) Minimum Equipment Requirements
  5. 5. (1) Ophthalmoscope(s)
  6. 6. (2) Tonometer
  7. 7. (3) Retinoscope
  8. 8. (4) Keratometer or Topographer
  9. 9. (5) Biomicroscope or Slit Lamp
  10. 10. (6) Phoropter or trial frame, trial lenses, and prisms
  11. 11. (6) Phoropter or trial frame, trial lenses, and prisms
  12. 12. (7) Standard Acuity Charts
  13. 13. (8) Field Testing Equipment
  14. 14. Certified Optometrist’s equipment  64B13-3.011 (4) (c) 3. Goldmann applanation tonometer 4. Static threshold visual field unit 5. Gonioscope 6. Fundus camera 7. Biomicroscope 8. Stereoscopic view of optic nerve using lenses such as digital high mag, Volk 90, hruby lens
  15. 15. Goldmann Tonometer
  16. 16. Visual Field Unit
  17. 17. Gonioscope
  18. 18. Fundus Camera
  19. 19. Biomicroscope or Slit Lamp
  20. 20. Stereoscopic Viewing Lenses
  21. 21. Foreign Body Removal 463.014 (4) Surgery of any kind, including the use of lasers, is expressly prohibited. Certified optometrists may remove superficial foreign bodies. For the purposes of this subsection, the term "superficial foreign bodies" means any foreign matter that is embedded in the conjunctiva or cornea but which has not penetrated the globe.
  22. 22. Foreign Body Removal Tools  Spud  Disposable Syringe Needle  Alger Brush
  23. 23. Spud
  24. 24. Disposable Syringe Needle
  25. 25. Alger Brush
  26. 26. Distinction of Duties in the office  463.002 Definitions 6) "Direct supervision" means supervision to an extent that the licensee remains on the premises while all procedures are being done and gives final approval to any procedures performed by an employee.
  27. 27. Distinction of Duties in the office  463.002 Definitions7) "General supervision" means the responsible supervision of supportive personnel by a licensee who need not be present when such procedures are performed, but who assumes legal liability thereof. Except in cases of emergency, "general supervision" shall require the easy availability or physical presence of the licensee for consultation with and direction of the supportive personnel.
  28. 28. Distinction of Duties in the office  463.009 Supportive personnel.--No person other than a licensed practitioner may engage in the practice of optometry as defined in s. 463.002(5). Except as provided in this section, under no circumstances shall non-licensed supportive personnel be delegated diagnosis or treatment duties; however, such personnel may perform data gathering, preliminary testing, prescribed visual therapy, and related duties under the direct supervision of the licensed practitioner. Non-licensed personnel, who need not be employees of the licensed practitioner, may perform ministerial duties, tasks, and functions assigned to them by and performed under the general supervision of a licensed practitioner, including obtaining information from consumers for the purpose of making appointments for the licensed practitioner. The licensed practitioner shall be responsible for all delegated acts performed by persons under her or his direct and general supervision.
  29. 29. Typical Optometric Violations  463.007 Renewal of license; continuing education.-- 3) Unless otherwise provided by law, the board shall require licensees to periodically demonstrate their professional competence, as a condition of renewal of a license, by completing up to 30 hours of continuing education during the 2-year period preceding license renewal. For certified optometrists, the 30-hour continuing education requirement shall include 6 or more hours of approved transcript-quality coursework in ocular and systemic pharmacology and the diagnosis, treatment, and management of ocular and systemic conditions and diseases during the 2-year period preceding application for license renewal.
  30. 30. Typical Optometric Violations  463.016 Grounds for disciplinary action; action by the board.- f) Advertising goods or services in a manner which is fraudulent, false, deceptive, or misleading in form or content.
  31. 31. Typical Optometric Violations  463.014 Certain acts prohibited.--  (1)(a) No corporation, lay body, organization, or individual other than a licensed practitioner shall engage in the practice of optometry through the means of engaging the services, upon a salary, commission, or other means or inducement, of any person licensed to practice optometry in this state. Nothing in this section shall be deemed to prohibit the association of a licensed practitioner with a multidisciplinary group of licensed health care professionals, the primary objective of which is the diagnosis and treatment of the human body.
  32. 32. Proper Entrance Sign
  33. 33. Proper Display of License
  34. 34. Other Equipment Needed but not required
  35. 35. Other Equipment Needed but not required
  36. 36. Other Equipment Needed but not required
  37. 37. Thank You

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