22 TAC §277.7
The Texas Optometry Board proposes new rule §277.7 in
order to establish minimum standards for patient records which will permit
the enforcement of Texas Optometry Act §351.353, which sets out the procedures
required in the initial examination of a patient.
Lois Ewald, executive director of the Texas Optometry Board, has determined
that for the first five-year period the new rule is in effect, there will
be no fiscal implications for state and local governments as a result of enforcing
or administering the rule.
Lois Ewald also has determined that for each of the first five years the
new rule is in effect, the public benefit anticipated as a result of enforcing
the new rule is that the public will be assured that the Board is properly
investigating its licensees' compliance with statutory examination requirements.
It has also been determined that the new rule does not impose any additional
costs on persons required to comply with the new rule (the Board's licensees),
since licensees currently meeting the required standard of care will be in
compliance with the provisions of the new rule. Therefore the new rule does
not impose any new duties on small and micro businesses, and no adverse economic
effect on small or micro businesses is forecast.
Comments on the proposal may be submitted to Lois Ewald, Executive Director,
Texas Optometry Board, 333 Guadalupe Street, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is thirty days after publication in the
Texas Register.
The amendment is proposed under the Texas Optometry Act, Texas
Occupations Code, §§351.151 and 351.353.
The Texas Optometry Board interprets §351.151 as authorizing the adoption
of procedural and substantive rules for the regulation of the optometric profession.
The Board interprets §351.353 to require the performance of certain procedures
in an initial eye examination. No other section is affected by the rule.
§277.7.Patient Records.
(a)
In order to protect the patient's health, an optometrist
or therapeutic optometrist shall create and maintain a legible and accurate
written patient record for each patient. Every patient record shall provide
sufficient information such that:
(1)
another optometrist or therapeutic optometrist can identify
the examination performed and the results obtained, and
(2)
the Board can accurately assess a licensee's compliance
with §§279. 5 and 279.7 of this title, and Optometry Act §351.353.
(b)
This rule is adopted to assist the Board in determining
whether a licensee has complied with the requirements of Optometry Act §351.353,
Initial Examination of Patient. This rule is not adopted to establish a standard
of care for the practice of optometry.
(c)
Notations to a detailed preprinted checklist are acceptable
if the results of an examination may clearly and accurately be presented in
this format. The use of a check mark or similar minimal notation to record
the performance of an examination, if not made to a detailed checklist, does
not meet the requirements of subsection (a). Any patient record that is created
or maintained in an electronic format must have the capability of printing
a paper record that meets the requirements of this rule.
(d)
The patient record for each initial examination for which
an ophthalmic lens prescription is signed shall contain, at a minimum, written
notations recording the procedures and findings required by §§279.5
and 279.7 of this title, and Optometry Act §351.353, in the following
format:
(1)
An accurate identification of the patient;
(2)
The date of the examination;
(3)
The name of the optometrist or therapeutic optometrist
conducting the examination;
(4)
Past and present medical history, including complaint presented
at visit;
(5)
A numerical value of the monocular uncorrected or monocular
corrected visual acuity in a standard acceptable format;
(6)
The results of a biomicroscopic examination of the lids,
cornea, and sclera;
(7)
The results of the internal examination of the media and
fundus, including the optic nerve and macula, all recorded individually;
(8)
The results of a retinoscopy. A tape from an automatic
refractor is acceptable;
(9)
The subjective findings of the examination. A tape from
a computer assisted refractor/photometer is acceptable if the instrument is
being used to obtain subjective findings;
(10)
The results of an assessment of binocular function, including
the test used and the numerical endpoint value;
(11)
The amplitude or range of accommodation expressed in numerical
endpoint value including the test used in the examination;
(12)
A tonometry reading including the type of instrument used
in the examination; and
(13)
Angle of vision: the extent of the patient's field to
the left and right.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on March 1, 2001.
TRD-200101226
Lois Ewald
Executive Director
Texas Optometry Board
Earliest possible date of adoption: April 15, 2001
For further information, please call: (512) 305-8500