Call me silly..
But what I was interpreting was the list of components was just that.. a list of steps that are to be taken if performing a comprehensive exam.
(5) Eye Examination Requirements - All eye examinations performed by licensees shall include the
professionally recognized components listed in subpart (3) (a) 2. (i) of rule 1045-2-.08 for spectacles and
in subpart (3) (a) 2. (ii) of rule 1045-2-.08 for contact lenses...................................................... ...
2. If an optometrist advertises an examination fee or includes an examination as a service
provided in an advertised fixed fee the examination findings shall include all pertinent
tests and observations necessary to satisfy the standard of care. The following shall
constitute the professionally recognized components to be included in the examination
provided for the advertised fee and before the prescription requested is issued:
(i) Spectacles
(I) Visual acuity testing of each eye far and near point; and
(II) External examination including extra ocular motility and confrontation
fields, and
(III) Refraction (objective and subjective); and
(IV) Co-ordination testing; and
(V) Opthalmoscopy; and
(VI) Biomicroscopy; and
(VII) Tonometry.
(ii) Contact Lenses:
(I) All of the components required for spectacles prescriptions; and
(II) Keratometer reading of cornea curves; and
(III) Biomicroscopic evaluation of lid health, tear film integrity and corneal
integrity; and
(IV) Application of known diagnostic lenses to each eye to include evaluation of
acuity, over refraction and biomicroscopic evaluation of lens fit with use of
chemical dyes as indicated; and
(V) Adequate patient training in lens care, solutions, application and removal
along with proper wearing schedule, warning signs, and recall intervals; and
(VI) A minimum of two follow up visits over a minimum period of 2 months
which shall occur prior to determining the contact lens prescription. At each
visit visual acuity and biomicroscopic evaluation of the eyes with and
without lenses will be performed.
When it goes to specify that it must include 2 follow up visits, etc.. that to me is clarifying what the doc should be doing, but not eliminating what a optician, COT/COA or orthopist can do if allowed under their regulations.
For example, I do not know of any optometrist that does his or her own Insertion/Removal instruction. Typically they assign the appropriate person employed to take care of that item with the patient. Same as those who perform pretesting items.
Tennessee also have makes the use of orthopist to perform vision therapy in conjunction with a OD/MD. Once again, the doctor does not perform this function themselves, but makes sure an appropriately trained person does.
Cassandra
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