CHAPTER 5
STANDARDS OF PRACTICE
Section 1. Authority. The Board is authorized under Wyoming Statute 33-23-116 to promulgate rules and regulations related to the standards of optometry practice in Wyoming.
Section 2. Practice of Optometry.
(a) The practice of optometry occurs where the patient is located or receives services regardless of means, in person or electronic.
(b) Furnishing or providing a contact or ophthalmic lens prescription is the practice of optometry.
Section 3. Optometric Procedures and Training.
(a) Licensees shall only use devices and treatments for which they are appropriately trained. All treatment shall be necessary and within the scope of practice defined within W.S. 33-23-101. The licensee shall demonstrate to the Board competency, training, and/or expertise should their ability to use a specific device or treatment be called into question.
(b) The following laser procedures shall be within the scope of practice of optometry:
(i) Laser Peripheral Iridotomy;
(ii) Selective Laser Trabeculoplasty; and
(iii) Yag Capsulotomy.
(c) Requirements for Laser Procedures and Treatment of the Adnexa of the Eye. Licensees who provide laser procedures in subsection (b) above or treat the adnexa of the eye shall demonstrate competency and training prior to performing these procedures.
(i) To perform laser procedures and treat the adnexa of the eye, a licensee shall:
(A) Complete one of the following education and examination requirements:
(I) Graduate from an accredited college or university of optometry where the laser procedures in subsection (b) and adnexa treatment were taught and passage of the NBEO Laser and Surgical Procedures Examination, or
(II) Complete a board-approved training course; and
(B) Satisfactorily complete a proctored session within two (2) years prior to performing laser surgical procedures. Proctoring may be performed by:
(I) An optometrist or ophthalmologist licensed to perform the procedures in subsection (b) in any jurisdiction; or
(II) An optometrist who has previously been proctored.
(ii) If a licensee has not performed a laser procedure within two (2) years, the licensee shall satisfactorily complete another proctored session.
(iii) Licensees performing the procedures in this section shall report to the Board any adverse outcomes following each procedure. These reports and corresponding patient records shall be received by the Board office within ten (10) days following the date the licensee is aware of the adverse outcome.
(iv) Licensees shall maintain documentation evidencing completion of the requirements in subsection (c)(i) above, and shall provide documentation to the Board upon request.
(d) Performing any of the procedures in subsection (b) without meeting the requirements in subsection (c) may subject the licensee to discipline for deviating from the standard of care, and subject to disciplinary action under Chapter 7, Section 2(d)(iii)(B).
Section 4. Contact and Ophthalmic Lens Prescriptions.
(a) Expiration of Prescriptions.
(i) Contact lens prescriptions shall expire one (1) year from the date of issuance.
(ii) Ophthalmic lens prescriptions shall expire two (2) years from the date of issuance.
(iii) A licensee may set an expiration date of earlier than one (1) or two (2) year expiration periods identified above only if that date is based on the licensee's medical judgment about the patient's eye health. In these cases, the licensee shall document the medical reason for the shorter expiration date with enough detail to allow for review by a qualified medical professional. The licensee shall also maintain these records for at least three (3) years.
(b) Providing Prescriptions. Licensees shall:
(i) Provide the contact lens prescription to the patient at the end of the contact lens fitting.
(ii) Provide or verify the contact lens prescription to anyone who is designated to act on behalf of the patient.
Section 5. Records Retention.
(a) Licensees shall not withhold records if a patient owes an outstanding balance.
(b) Patient records shall be:
(i) Maintained for a minimum of seven (7) years from the date of the last patient clinical encounter;
(ii) Maintained in a physically secure and confidential manner; and
(iii) Accessible to the patient and treating doctor within a reasonable period.
Section 6. Use of Optometry Assistants. A licensee may employ an optometry assistant(s). All optometry assistants shall practice under the licensee's general supervision.
(a) General supervision means the procedures are performed under a licensee's overall direction and control. The licensee's physical presence is not required during the performance of the procedures. The training of assistants who actually perform the diagnostic procedure and maintain necessary equipment and supplies is the continuing responsibility of the licensee.
(i) Assistants shall not write orders.
(ii) The testing of patients can only be performed upon the verbal or written direction of the licensee.
(iii) The physical presence of the licensee is not required if the assistant can easily contact the licensee. Treatment plans, however, can only be directed once the licensee physically reviews test results.
(b) An assistant cannot, in any manner, practice optometry.
(c) The Board does not recognize nor bestow any level of competency upon an assistant to carry out a specific task. Such recognition of skill is the responsibility of the licensee.
Section 7. Externships.
(a) An externship is when an optometric student is allowed to practice optometry in a clinical setting under the direct supervision of a licensee.
(b) The licensee shall comply with all necessary documentation and contracts to become an outreach facility with an optometric institution.
(i) The educational institution and the licensee bear liability for all acts and omissions of the extern.
(ii) Direct supervision means the licensee must be physically present in the office and immediately available to assist and direct throughout the performance of the procedure. It does not mean that the licensee must be present in the room when the procedure is being performed.