As a Licensed Optician certified to perform independent automated refractions, you explain to your client that you can perform a sight test. You also advise them that is this is not the same as an eye health examination. You review your business’s fees for sight testing with your client and explain that no fees will be charged for the service if any issues arise that indicate a need for an eye health examination. You also explain that you cannot charge for a copy of the assessment record, which is the record you will produce outlining the sight test results.
Next, your client must review and complete the mandatory paperwork. The first document you provide to the client is the Client Information Sheet, Form 1A. The information sheet explains what a sight test is and what it does and does not include. You review the information sheet with your client to help them understand the scope of the service and address any questions or concerns they may have. Then, you ask the client to complete Form 1B: Client History & Eligibility. Forms 1A and 1B must be reviewed/completed by the client before the sight test is performed.
Here’s what you now know about your client:
- They are a 45-year-old with no known medical or ocular conditions.
- They have no family history of medical or ocular conditions.
- Their most recent eye exam was completed by an optometrist 2 years ago.
You double-check the Eligibility Checklist or Eligibility Flow Chart to ensure that your client is eligible for a sight test. You determine that they are eligible because of the date of their most recent eye health examination (which happened since they turned 40).
You complete the sight test and produce an assessment record, which contains the results of the independent automated refraction, as well as the client’s pupillary distance. You provide a copy of the assessment record to your client and charge them the agreed-upon fee for the sight test. You then assist your client in picking lenses and frames to fit their vision needs.
General requirements for performing an independent automated refraction
You must help your client to understand the difference between a sight test and an eye examination. Remember that your client must review Form 1A and complete Form 1B before you can proceed with a sight test. Of course, you must also ensure that the client is eligible for a sight test—and if they are not eligible, you must be prepared to explain the reasons.
Keep clear and well-documented records in the client record, as per the Record Keeping Checklist. Importantly, ensure that the client record contains their assessment record, which details the results of their independent automated refraction as well as their pupillary distance.
The client must be provided with a copy of the assessment record after the service is completed, whether they request it or not. You cannot charge the client for this first copy of the assessment record; however, you can charge for duplicate copies. You can also charge a fee for the sight testing service itself, in accordance with your business’s policies.
These requirements come from the Opticians Regulation and are not optional.
Case Study #2
A client referred by a prescriber
A 65-year-old diabetic client has just had their second cataract surgery and now needs a new pair of eyeglasses. Due to their age and medical conditions, they are only eligible for an independent automated refraction if their ophthalmologist or optometrist, who has already performed an eye health examination, requests one.
This client had an eye examination performed by their ophthalmologist recently. Their ophthalmologist has referred them to you to complete a sight test and dispense new eyeglasses. Since the client was referred to you, you are not required to provide Form 1A or have the client complete Form 1B. However, because you are not using Form 1B, you make a point of collecting and documenting all of the necessary personal information separately.
You are still obligated to obtain informed consent from the client before and during the sight test. Once the sight test is complete, you provide the client with their assessment record and update the client record—being sure to include a copy of the referral letter.
Requirements for performing an independent automated refraction on a referred client
A client who does not otherwise meet the criteria for an independent automated refraction with an optician may be eligible if referred to the optician by a prescriber.
Under these circumstances, it is essential to document the details of the independent automated refraction, including the fact that the client has been referred by a prescriber who has already completed an eye health examination on the client. Be sure to keep a copy of the referral letter.
Certain aspects of the process will be just the same as they would be with any other client. You must always ensure that your client provides informed consent for a sight test, and you must always communicate the cost of the sight test prior to service. Additionally, the obligation to provide a copy of the assessment record to the client, including pupillary distance, remains the same. You should obtain the client’s verbal and/or written consent before sending a copy of the assessment record to the referring prescriber.