64B13-3.007. Minimum Procedures for Comprehensive Eye Examination

(1) A comprehensive eye examination is defined as a comprehensive assessment of the patient’s visual status and shall include those procedures specified in subsection (2) below.

(2) A comprehensive eye examination shall include the following minimum procedures, which shall be recorded on the patient’s case record:

(a) Patient’s history (personal and family medical history, personal and family ocular history, and chief complaint);

(b) Visual acuity (unaided and with present correction at initial presentation; thereafter, unaided or with present correction);

(c) External examination;

(d) Pupillary examination;

(e) Visual field testing (confrontation or other);

(f) Internal examination (recording, optic nerve health, blood vessel status, macula health, and any abnormalities);

(g) Biomicroscopy (binocular or monocular);

(h) Tonometry; (with time of measurement);

(i) Refraction (with recorded visual acuity);

(j) Extra ocular muscle balance assessment;

(k) Other tests and procedures that may be indicated by case history or objective signs and symptoms discovered during the comprehensive eye examination;

(l) Diagnosis and treatment plan.

(3) If because of the patient’s age or physical limitations, one or more of the procedures specified herein or any part thereof, cannot be performed, or if the procedures or any part thereof are to be performed by reason of exemption from this rule, the reason or exemption shall be noted on the patient’s case record.

(4) Except as otherwise provided in this rule, the minimum procedures set forth in subsection (2) above shall be performed prior to providing optometric care during a patient’s initial presentation, and thereafter at such appropriate intervals as shall be determined by the optometrist’s sound professional judgment: provided, however, that each optometric patient shall receive a comprehensive eye examination prior to the provision of further optometric care if the last comprehensive eye examination was performed more than two years before.

(5) Whenever a patient presents to a licensed practitioner or certified optometrist with any of the following as the primary complaint, the performance of the minimum procedures set forth in subsection (2) above shall not be required.

(a) Emergencies;

(b) Trauma;

(c) Infectious disease;

(d) Allergies;

(e) Toxicities; or

(f) Inflammations.

(6) The minimum procedures set forth in subsection (2) above shall not be required in the following circumstances:

(a) When a licensed practitioner or certified optometrist is providing specific optometric services on a secondary or tertiary basis in patient co-management with one or more health care practitioners skilled in the diagnosis and treatment of diseases of the human eye and licensed pursuant to Chapter 458, 459, or 463, Florida Statutes;

(b) When a licensed practitioner or certified optometrist is providing consultative optometric services on a limited basis at the request of one or more health care practitioners licensed pursuant to Chapter 458, 459, or 463, Florida Statutes. Such services shall be provided with the patient’s full knowledge of the limited nature of the optometric care. The name of the requesting health care practitioner and the optometric care provided shall be noted on the patient’s case record;

(c) When a licensed practitioner or certified optometrist performs public service visual screenings or visual screenings for governmental agencies and each recipient of such screening is clearly informed in writing of the following:

1. The limitations of the screening;

2. That the screening is not representative of or a substitute for a comprehensive eye examination; and

3. That the screening will not result in a prescription for visual correction.

(d) Drug therapy and contact lens research.

(7) Nothing within this rule shall be read to exempt any licensed practitioner or certified optometrist from the requirements of Section 463.0135, Florida Statutes.

Specific Authority 463.005(1) FS. Law Implemented 463.005(1), 463.0135, 463.016(1)(g), (k) FS. History–New 11-13-79, Amended 4-17-80, 7-29-85, Formerly 21Q-3.07, Amended 7-18-90, Formerly 21Q-3.007, 61F8-3.007, 59V-3.007, Amended 4-3-00, 4-5-04, 6-5-06, 11-5-07, 11-4-08.