The document summarizes optometry laws and regulations in Florida, including: 1) What constitutes a complete eye exam according to state law, including required tests and documentation. 2) The minimum equipment an optometrist must have to perform exams, including an ophthalmoscope, tonometer, retinoscope, and phoropter. 3) Additional equipment that certified optometrists must have to provide advanced care, such as a Goldmann tonometer and fundus camera. 4) Guidelines around supportive staff duties, advertising, continuing education requirements, and other typical regulatory violations.

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. 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. 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. 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. (1) Ophthalmoscope(s)

6. (2) Tonometer

7. (3) Retinoscope

8. (4) Keratometer or
Topographer

9. (5) Biomicroscope or Slit
Lamp

10. (6) Phoropter or trial frame,
trial lenses, and prisms

11. (6) Phoropter or trial frame,
trial lenses, and prisms

12. (7) Standard Acuity Charts

13. (8) Field Testing Equipment

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. Goldmann Tonometer

16. Visual Field Unit

17. Gonioscope

18. Fundus Camera

19. Biomicroscope or Slit Lamp

20. Stereoscopic Viewing Lenses

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. Foreign Body Removal Tools
 Spud
 Disposable Syringe Needle
 Alger Brush

23. Spud

24. Disposable Syringe Needle

25. Alger Brush

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. 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. 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. 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. 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. 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. Proper Entrance Sign

33. Proper Display of License

34. Other Equipment Needed but
not required

35. Other Equipment Needed but
not required

36. Other Equipment Needed but
not required

37. Thank You