Plain language analysis:
The proposed rule clarifies that it is unprofessional conduct for an optometrist to fail to conduct certain procedures during a minimum eye examination and a minimum eye examination for the fitting of contact lenses.
It also removes the requirement that optometrists provide a written disclosure to extended wear contact lens patients describing the risks associated with extended wear contact lenses. The language in the rule is outdated and rewriting the disclosure statement would place unnecessary administrative requirements on optometrists. The public is protected by s. 449.25 (1), Stats., designating a “reasonable optometrist” standard requiring “…disclosure only of information that a reasonable optometrist would know and disclose under the circumstances.” The proposed rule removes the requirement that optometrists make a notation in the patient file that ophthalmic lenses have been verified prior to dispensing and that they verify that ophthalmic lenses meet an obsolete American National Institute Standards, Inc. (ANSI) standard prior to dispensing.
It also clarifies that where the patient is a minor or is an incompetent person, informed consent must be received from the patient’s parent or legal guardian prior to treatment.
Summary of, and comparison with, existing or proposed federal regulation:
No existing or proposed federal regulations relate to disclosure to patients of risks associated with extended wear contact lens or verification of technical standards for ophthalmic lenses prior to dispensing to a patient.
Summary of public comments received on statement of scope and a description of how and to what extent those comments and feedback were taken into account in drafting the proposed rule:
Comparison with rules in adjacent states:
Illinois:
No existing or proposed Illinois regulations relate to disclosure to patients of risks associated with extended wear contact lens or verification of technical standards for ophthalmic lenses prior to dispensing to a patient.
Iowa:
No existing or proposed Iowa regulations relate to disclosure to patients of risks associated with extended wear contact lens or verification of technical standards for ophthalmic lenses prior to dispensing to a patient.
Michigan:
No existing or proposed Michigan regulations relate to disclosure to patients of risks associated with extended wear contact lens or verification of technical standards for ophthalmic lenses prior to dispensing to a patient.
Minnesota:
No existing or proposed Minnesota regulations relate to disclosure to patients of risks associated with extended wear contact lens or verification of technical standards for ophthalmic lenses prior to dispensing to a patient.
Summary of factual data and analytical methodologies:
The Optometry Examining Board performed a comprehensive review of chapter Opt 5. This rule project reflects the Board’s efforts to revise the chapter for clarity, remove obsolete provisions, and ensure the chapter is current with professional standards and practices.
Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis:
The proposed rules were posted for a period of 14 days to solicit public comment on economic impact, including how the proposed rules may affect businesses, local government units, and individuals. No comments were received.
Fiscal Estimate and Economic Impact Analysis:
The Fiscal Estimate and Economic Impact Analysis are attached.
Effect on small business:
These proposed rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator may be contacted by email at Daniel.Hereth@wisconsin.gov, or by calling (608) 267-2435. Agency contact person:
Dana Denny, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, 4822 Madison Yards Way, P.O. Box 8366, Madison, Wisconsin 53708; telephone 608-287-3748; email at DSPSAdminRules@wisconsin.gov. ------------------------------------------------------------------------------------------------------------
TEXT OF RULE
SECTION 1: Opt 1.02 (2) is repealed.
SECTION 2: Opt 1.02 (4) and (5) are repealed and recreated to read:
Opt 1.02 (4) “Minimum eye examination” means performance of all of the following procedures:
(a) Recording a complete case history of the patient.
(b) Measuring far and near visual acuity.
(c) Conducting an internal and external examination of the eye and adnexa.
(d) Measuring corneal curvature.
(e) Obtaining objective measurement of refractive error.
(f) Evaluating convergence and accommodation.
(g) Obtaining far and near refraction.
(h) Evaluating muscle balance.
(i) Measuring intraocular pressure.
(j) Recording spectacle prescription including far and near visual acuity.
Opt 1.02 (5): “Minimum eye examination for the fitting of contact lenses" means the performance of all of the following procedures:
(a) Performing the minimum eye examination procedures under sub. (4).
(b) Determining whether a patient may safely and comfortably wear contact lenses.
(c) Using a spectacle prescription as a basis for selecting, designing, manufacturing, or duplicating a contact lens.
(d) Placing a trial contact lens upon the eye of a patient for diagnostic purposes.
(e) Evaluating the physical fit of the trial contact lens.
(f) Using a phoropter, hand-held lens or any automated instrument for the purposes of determining the prescription or change in prescription of a contact lens.
(g) Determining contact lens specifications.
(h) Counseling the patient on all the following:
1. The proper care and use of the prescribed contact lenses.
2. The appropriate contact lens wearing schedule.
3. Contact lens replacement schedule.
(i) When contact lenses are prescribed for extended wear, informing the patient of the potential risks or complications.
(j) Performing progress evaluations and recording in the patient record the recommended date of the patient's next visit.
SECTION 3: Opt 1.02 (5m) is created to read:
