Optometric Practice Reference
The Optometric Practice Reference (OPR) articulates the current regulatory and professional standards of practice for optometry in Ontario and provides voluntary guidelines for practitioners wishing to go beyond the basic requirements. The OPR replaces the Guide to the Practice of Optometry (2000) and all previous versions of the Guide.
The OPR is a valuable reference for members of the College and is also intended to be a resource for patients, College Committees and the general public. As a living document, it will be updated and new documents will be added on a regular basis. Read the latest version of the OPR (September 2022) below.
If you wish to access older published versions of the OPR, please contact our practice advisors.
OPR Changes At-a-glance
Below is an overview of the most recent changes to the OPR. Review the full standard in the OPR for a more comprehensive look into the changes. If you have any questions regarding any of the changes, please contact firstname.lastname@example.org.
OPR 4.2 REQUIRED CLINICAL INFORMATION
In emergency or urgent situations, it may be impractical to obtain all clinical information at the first visit. In such cases, specific assessment is appropriate (OPR 4.6). The practitioner may advise the patient to seek a full comprehensive eye exam within a reasonable time frame or may send a report to their primary optometrist for continuation of care.
OPR 4.5 REFERRALS
Wet AMD was added to acute conditions that pose an immediate threat to the health and/or vision of the patient requiring a prompt referral.
OPR 4.7 INFECTION CONTROL IN THE OPTOMETRIC OFFICE
A statement was added to the section, stating optometrists should follow the recommendations of their local public health units regarding infection control in the optometric office.
OPR 4.8 COLLABORATION AND SHARED CARE
A section was added regarding intra-professional collaborative practice among optometrists. An optometrist may refer to another optometrist for specific assessment and treatment. The primary, referring optometrist, must communicate to the patient what their role will be during the referral process and protocol for further follow up. A requisition from the referring optometrist must include pertinent clinical information. The optometrist who accepts the requisition must communicate to the patient the nature of their role, including which elements of care they are responsible for and the anticipated duration of care. The optometrist must maintain a patient health record including the requisition information and results. Any new symptoms or concerns should be referred back to the primary optometrist as they are responsible for the components of a comprehensive eye examination.
OPR 6.1 ANTERIOR SEGMENT EXAMINATION
Anterior segment examination was amended so that documentation of sclera findings is required only when clinically indicated.
OPR 6.8 VISUAL FIELD ASSESSMENT
If optometrists do not have the required instrumentation, arrangements must be in place whereby the appropriate testing will be performed elsewhere in a timely fashion. Several paragraphs on intra-professional care were removed from this section. Members are now encouraged to review the recently updated OPR 4.8 Collaboration and Shared Care for further guidance.
OPR 7.9 PATIENTS WITH LEARNING DISORDERS
The terminology “Learning Disability” was changed to “Learning Disorders.” Recommendations were added for assessment, counselling and referral when providing care to patients with suspected or recognized learning disorders.
OPR 7.10 ORTHOKERATOLOGY
The terminology from “myopia control” was changed to “myopia management.” Clarification was provided to state optometrists must present a realistic prognosis when offering Orthokeratology, especially as it pertains to the amount of myopia reduction and/or the realistic myopia management prognosis for patients. Parent, in addition to guardian, was added as a substitute decision maker if a patient is unable to consent to treatment.
OPR 7.14 MYOPIA MANAGEMENT
Recognizing that myopia management has advanced to include specialty contact lenses, specialty spectacle lenses and pharmaceutical treatment, a new standard was created: OPR 7.14 Myopia Management.