O-7, r. 11.1 - Regulation respecting the medications that may be administered and prescribed by an optometrist and respecting the eye care that may be provided by an optometrist

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chapter O-7, r. 11.1
Regulation respecting the medications that may be administered and prescribed by an optometrist and respecting the eye care that may be provided by an optometrist
OPTOMETRY — MEDICATION AND PRESCRIPTION
Optometry Act
(chapter O-7, s. 19.4).
O-7
June 20 2018July 19 2018
DIVISION I
MEDICATIONS THAT MAY BE ADMINISTERED BY AN OPTOMETRIST
845-2018, Div. IO.C. 845-2018, Div. I.
1. An optometrist who holds a permit referred to in the first paragraph of section 19.2 of the Optometry Act (chapter O-7) may administer the medications and substances listed in Schedule I for the sole purpose of eye examinations.
845-2018O.C. 845-2018, s. 1.
DIVISION II
MEDICATIONS THAT MAY BE ADMINISTERED AND PRESCRIBED FOR THERAPEUTIC PURPOSES BY AN OPTOMETRIST AND THE EYE CARE THAT MAY BE PROVIDED BY AN OPTOMETRIST
845-2018, Div. IIO.C. 845-2018, Div. II.
2. This Division applies only to optometrists who hold a permit referred to in the second paragraph of section 19.2 of the Optometry Act (chapter O-7).
845-2018O.C. 845-2018, s. 2.
3. An optometrist may administer and prescribe the medications and substances listed in Schedule I for treating a condition of mild morbidity of the eye and adnexa, or any other condition provided for in this Regulation.
845-2018O.C. 845-2018, s. 3.
4. For the treatment of a condition of mild morbidity of the eye and adnexa or the prevention of such a condition, an optometrist may provide the following eye care:
(1)  non surgical care related to the anterior segment of the eye and adnexa;
(2)  removal of a superficial foreign body from the eye and complementary care required following the removal;
(3)  punctal occlusion;
(4)  heat, mechanical or manual treatment of meibomian glands and eyelashes;
(5)  application of therapeutic contact lenses.
845-2018O.C. 845-2018, s. 4.
5. Subject to section 6, an optometrist may administer and prescribe an anti-glaucoma medication for the treatment of a glaucoma condition where the following requirements are met:
(1)  the condition may be described as follows:
(a)  glaucoma suspect;
(b)  early glaucoma;
(c)  steroid-induced glaucoma;
(2)  the optometrist has access to the appropriate instruments for the assessment of the condition.
An optometrist who administers or prescribes an anti-glaucoma medication in accordance with the first paragraph must, thereafter, refer the patient to an ophthalmologist physician for medical follow-up.
845-2018O.C. 845-2018, s. 5.
6. Where a patient’s follow-up is ensured by an ophthalmologist physician, the administration or prescription of an anti-glaucoma medication by the optometrist must conform to the treatment established by that physician or comply with the joint follow-up plan agreed to with the physician and entered in the patient’s record.
845-2018O.C. 845-2018, s. 6.
7. Despite section 5, an optometrist may administer and prescribe an anti-glaucoma medication for the treatment of any glaucoma condition if the optometrist has obtained, before each administration or prescription, the consent of a physician who has already assessed the patient or agrees to provide consultative care to the patient. The optometrist must then enter in the patient’s record the name and licence number of the physician from whom the optometrist obtained the consent.
845-2018O.C. 845-2018, s. 7.
8. Where an optometrist administers or prescribes a medication or provides eye care, the optometrist must refer the patient to a physician if the patient’s condition does not adequately respond to treatment in the accepted or anticipated amount of time and each time the patient’s interest requires it. An optometrist must also refer the patient to a physician if the signs and symptoms suggest a condition other than the condition referred to in section 3 or that requires a physician to take charge of the patient, in particular where there is the presence of
(1)  an infectious ulcer reaching the central cornea;
(2)  epithelial dendrites with stromal injury;
(3)  sectorial inflammation of the episclera with ischemia or melting;
(4)  sectorial inflammation of the anterior chamber with hypopyons, vitritis or atypical lesions of the cornea;
(5)  glaucoma other than those for which the optometrist is authorized to intervene pursuant to section 5.
845-2018O.C. 845-2018, s. 8.
DIVISION III
FINAL
845-2018, Div. IIIO.C. 845-2018, Div. III.
9. This Regulation replaces the Regulation respecting the medications that an optometrist may administer (chapter O-7, r. 10) and the Regulation respecting the medications that may be administered and prescribed for therapeutic purposes by an optometrist and respecting the eye care that may be provided by an optometrist (chapter O-7, r. 11).
845-2018O.C. 845-2018, s. 9.
10. (Omitted).
845-2018O.C. 845-2018, s. 10.
SCHEDULE I
(ss. 1 and 3)
1. All topical ophthalmic medications, except cocaine and extemporaneous preparations of antibiotics, subject to the following restrictions:
(1)  immunosuppressants, only for dry eye treatment;
(2)  except for the purposes referred to in sections 5 to 7 of the Regulation, the following anti-glaucoma medication used only for the following purposes:
(a)  miotics, for eye examination;
(b)  prostaglandin analogues, for the treatment of hypotrichosis.
2. The following oral medications:
(1)  antibiotics, excluding extemporaneous preparations, only for the treatment of cases where eyelids are affected, according to the protocol established by the Institut national d’excellence en santé et en services sociaux;
(2)  antivirals, only for the treatment of eye herpes, according to the protocol established by the Institut national d’excellence en santé et en services sociaux and for a maximum continuous period of 1 year.
3. Any other medication, vitamin or natural health, topical and oral product, that is not referred to in Schedule I to the Regulation respecting the terms and conditions for the sale of medications (chapter P-10, r. 12).
4. Any combination of medications, vitamins and natural health products in this Schedule is permitted subject to the restrictions provided for in the Schedule that apply to them.
845-2018O.C. 845-2018, Sch. I.
REFERENCES
O.C. 845-2018, 2018 G.O. 2, 2760