July 2025
Is IPL permitted?
The practice of optometry is the assessment of the eye and vision system and the diagnosis, treatment and prevention of prescribed diseases.
The College supports the use of evidenced-based techniques, instrumentation and therapies that have the support of peer-reviewed literature. IPL is permitted for the treatment of a prescribed disease, namely dry eye therapy and ocular rosacea. The practitioner must ensure the practice is supported by peer- reviewed literature, appropriate education and training, and abides by infection control principles.
Can an optometrist treat rosacea with IPL contributing to dry eye syndrome?
The practice of optometry is the assessment of the eye and vision system and the diagnosis, treatment and prevention of prescribed diseases.
Treating skin disorders outside the ocular adnexa is not within the scope of optometry.
It is best practice to work collaboratively with a medical practitioner whose scope is to treat skin disorders (i.e. physician, nurse practitioner) when a patient has both ocular and facial rosacea.
Are other forms of energy permitted to treat dry eye (ie. radiofrequency, electrostatic energy)?
The forms of energy that are prescribed for the purposes of this controlled act are listed in Ontario regulation 107/96 under the Regulated Health Professions Act, 1991 (RHPA): https://www.ontario.ca/laws/regulation/960107
There are many different forms of energy that are not listed as controlled acts in the RHPA. If a specific form of energy is not listed in this regulation, the RHPA does not restrict how or by whom that form of energy may be applied.
Registrants are encouraged to review this regulation to see if the energy falls under one of the restricted energies.
The College supports the use of evidenced-based techniques, instrumentation and therapies that have the support of peer-reviewed literature and that does not compromise patient safety
Optometrists are encouraged to use their own clinical and professional judgment and seek independent legal advice.
Can optometrists delegate dry eye treatments to trained staff?
Yes, an optometrist can assign dry eye treatments (ex. IPL) to trained staff.
Both delegation and assignment of optometric procedures in appropriate circumstances may allow a more timely and efficient delivery of optometric care, making optimal use of time and personnel.
In every instance of delegation and assignment, the primary consideration should be the best interests of the patient. It is a general expectation that optometrists will be responsible for and appropriately supervise all delegated and assigned activities within their practices. The level of supervision varies with the risk associated with the delegated or assigned procedure.
The responsibility for all aspects of any delegated acts or assigned procedures always remains with the optometrist.
Can optometrists prescribe autologous serum eyedrops (“ASEDs”)?
Autologous serum eyedrops (“ASEDs”) are made by drawing the patient’s own blood and using the serum to create eye drops. ASEDs are administered for a wide range of ocular surface disease.
Health Canada considers autologous cell therapy products to meet the definition of “drug.” ASEDs are a drug which is not on the list of those that optometrists are permitted to prescribe (ASEDs do not appear on Schedule 1 of Ontario Regulation 112/11). Additionally, medical laboratory technologists and employees of licensed laboratories and specimen collection centres are not permitted to draw blood on optometrists’ orders. Therefore, optometrists are not currently authorized to prescribe or order ASEDs in Ontario.
Optometrists may therefore discuss ASEDs with patients but refer to ophthalmology for prescriptions. Optometrists can also collaborate with the patient’s family physician to have the serum ordered.