Professional Practice FAQ’s

For the purpose of fitting contact lenses, can an optician neutralize a prescription from a patient’s existing eyeglasses?

Yes, however, this method should be the exception and not the norm.  It is best to work from an actual prescription to ensure you are providing the most accurate eyewear.

Before neutralization can occur,  it is essential for the optician to explain to the patient the importance of having regular eye examinations because such examinations may reveal the necessity for further correction.

The neutralization must be noted in the patient’s health record.  

If the prescription cannot be adequately obtained by neutralization (i.e. lenses are too scratched, frame is broken and does not support the lenses in the proper position in front of the eye, etc.) the optician should not use that prescription to reproduce another pair of eyeglasses or fit the patient with contact lenses and must obtain a valid prescription from an authorized prescriber.

If a patient refuses to comply with the recommended contact lens follow-up schedule, does an optician have the right to decline dispensing the supply of contact lenses?

Yes. At no time is an optician required to fill a prescription.  The primary consideration should always be the best interests of the patient.   

If a patient refuses to undergo a new eye examination, can an optician still dispense a supply of contact lenses?

Yes. It is always recommended that a patient has regular eye examinations, however, the optician is responsible for determining the appropriateness of any treatment plan that is provided to a patient.

The primary consideration should always be in best interests of the patient and at no time is an optician required to fill a prescription.

Can an optician dispense eyewear based on an ophthalmic prescription that was issued outside of Ontario or in another country?

Yes. Prescriptions originating in Canada or outside of Canada are acceptable provided that the prescription conforms to the criteria set out in Standard 3 of the Professional Standards of Practice. 

Can an individual who is not a licensed health care professional, replace nose pads or missing screws in a patient’s eyeglass frame?

Yes. Non-licensed individuals (i.e. sales associates) may assist the optician with minor repairs to eyeglasses, such as the replacement of screws or nose pads.  Any adjustments to the eyewear is considered dispensing and must be done by or under the supervision/delegation of a Registered Optician.

Where can I get more information for patients about the importance of visiting a Licensed/ Registered Optician?

The College of Opticians of Ontario supports the National Public Awareness Initiative of the Opticians Council of Canada.

Opticians can direct patients to www.LicensedOptician.ca to learn more about the importance of choosing a Licensed Optician for their vision care needs.

Opticians can sign up to:

• Obtain access to educational and awareness tools.
• Learn how to incorporate these tools into their practice.
• Obtain information about how they can get involved with the National Public Awareness Initiative. 

Can an optician dispense eyewear based on a prescription that has expired?

Opticians are expected to adhere to expiry dates indicated on optical prescriptions when dispensing prescription eyewear as the Optometric Practice Reference 5.2A put out by the College of Optometrists indicates all optical prescriptions must specify an expiry date.

Opticians are required to use professional judgment at all times in their practice. Any divergence from the expiry date indicated on the prescription must be recorded in the patient file, and the optician must communicate the potential risks to the patient and document the conversation in the patient file.

Privacy and Confidentiality

My employer does not keep hardcopies of patient health records and maintains only electronic records. Is this acceptable?

Yes. Electronic health records are acceptable provided that the health records conform to the criteria set out in the College of Opticians of Ontario’s Professional Standards of Practice.  The College does not dictate what form the health record should be stored in, only that it adhere to the Standards regarding record keeping.  

The optician must also retain a copy of the patient’s prescription for a minimum of seven years and must make available the original or copy of the prescription, when requested to do so.  

The prescription should include:   

• Date of examination
• Name and signature of the prescriber.

As such, if the optician is “scanning” a copy of the prescription which can clearly show a prescriber’s signature from a computer database, then a hardcopy (paper record) is not required. However, if the prescription details are simply inputted into a computer, the optician is required to produce proof of validity if it does not show the prescriber’s signature. A computer generated prescription without a prescriber’s signature will not be accepted by the College.

How must a registrant of the College of Opticians of Ontario appropriately handle patient health records?   

During the course of the patient/practitioner relationship personal health information is collected for patient records.   

Personal health information includes all of the information that is required to be recorded in the patient file as provided in the College’s Professional Standards of Practice, Standard 5 (Records).

Personal health information may also include information that is not required to be recorded in the patient file such as insurance information or a patient’s health card number. Registrants are obliged to collect the least amount of personal health information necessary that is consistent with the purposes for which it was collected. For example, collecting an individual’s Social Insurance Number is usually not necessary.

Confidentiality & Privacy - Registrants must take appropriate measures to safeguard all personal information, including personal health information, from unauthorized access, disclosure, use or tampering. The nature of those safeguards will vary depending on the sensitivity of the information and the circumstances.

Retention of Records - Registrants are required to comply with appropriate retention and destruction practices with regards to patient health records. In accordance with the College’s Professional Standards of Practice, records must be maintained in the dispensary for a minimum of seven years from the date of last entry to ensure that any services provided to a patient can be identified.

For more information regarding confidentiality, privacy and retention of records, please view the Ontario Information and Privacy Commissioner’s Guide to the Personal Health Information Protection Act.

A patient has requested information from their patient health record. Is an optician obligated to give out the patient’s measurements (i.e. pupillary distance measurement, keratometry readings, etc.)?

Yes. Under the Personal Health Information Protection Act, 2004 (PHIPA),  a patient has a right of access to his or her own personal health information and the optician has a corresponding obligation to provide access in accordance with PHIPA. The physical record of a patient’s personal health information belongs to the optician, but the personal health information contained within the record belongs to the patient.  

The above answer is a brief introduction to the right of access provided for in PHIPA. Registrants must read and be familiar with the College’s Access to Personal Health Information Policy and Explanatory Document  when responding to a patient’s request to access their personal health information.

Workplace Issues

How should registrants of the College of Opticians of Ontario manage professional boundaries?

Registrants are responsible for maintaining professional boundaries with patients. Professional boundaries are the threshold where a strictly professional relationship ends and a non-professional relationship begins. Non-professional relationships are social relationships, which may be casual, friendly, or romantic.

For example, if an optician wishes to date a patient, the patient relationship must first be terminated and arrangements should be made for another optician to treat the patient. The optician must then wait an acceptable period of time before beginning to date that patient. What constitutes an acceptable length of time is specific to the unique set of circumstances that surround each case.

Registrants are reminded that the College takes a zero tolerance approach to sexual abuse of patients. Under the Regulated Health Professions Act, an optician’s certificate of registration (license) may be revoked if he or she engages in sexual activity with a patient, regardless of whether the activity occurred in the course of a consensual relationship, including marriage. Opticians are strongly encouraged to consult with the College about their obligations prior to commencing a personal relationship with a former patient.

For more information on managing professional boundaries, please view the College’s Sexual Abuse Prevention Guidelines.

What is a registrant’s mandatory reporting obligation?

As registrants of one of Ontario’s regulated health Colleges, students, interns and opticians are legally obligated under the Regulated Health Professions Act, 1991 (RHPA) to file a written report if, during the course of practicing opticianry, they have reasonable grounds to suspect that a patient has been sexually abused by a registrant of either the same or a different regulated health profession. If the registrant is aware of the name of the registrant in question, a “mandatory report” must be filed with the Registrar of the College to which the registrant who is the subject of the report belongs.

Failure to file a mandatory report is an offence under the Regulated Health Professions Act and is punishable by a fine of up to $25,000 for a first offence and up to $50,000 for a second or any subsequent offence. It may also be considered an act of professional misconduct to fail to file a mandatory report.

Visit the Reporting Obligations page for more information.

Do you have a practice related question that has not been addressed here? 

If so, please email your question to practiceadvice@collegeofopticians.ca. Professional Practice FAQ’s are updated on a regular basis, so please come back often to see what new questions have been added to the list.