The public can expect that opticians who prepare written or electronic authorization that permits the ordering, fitting, and dispensing of personalized vision appliances are specifically authorized and competent to do so. A member of the public can also expect to receive a copy of their vision appliance record or prescription free of charge.

This appendix applies to all opticians preparing dispensing authorities or fitting contact lenses. It must be read in conjunction with the Ethics and Practice Standards, all of which apply.

1. Preparing a dispensing authority
   An optician must:
   1. Be certified by CHCPBC to perform this activity.
   2. Prior to conducting an automated refraction, explain—and document any discussion related to—the nature, purpose, intended benefits, limitations, risks, and alternatives to automated refraction, including:
      1. That automated refraction is not an eye health examination and is distinct from an eye health examination conducted by an appropriately qualified healthcare professional.
      2. That automated refraction is not permitted for any patient who:
         1. Is under 19 years of age, is 65 or older, or has not had an eye health examination since turning 19 or 40.
         2. Has a history of:
            1. Glaucoma, retinal detachment, macular degeneration, or diplopia.
            2. An ocular motility disorder or binocular vision dysfunction.
            3. Total refractive error exceeding ±6.00 dioptres in either eye.
            4. Total change in refractive power of more than ±1.00 dioptre in 6 months, or more than ±2.00 dioptres since their most recent prescription or dispensing authority.
            5. Diabetes or hypertension.
            6. Head or brain injury within the past 12 months, or ongoing symptoms such as headache, dizziness, blurred vision, loss of consciousness, or cognitive impairment that may affect visual function.
            7. Eye injury or pain within the preceding 3 months.
         3. Remains dissatisfied with best corrected vision after two automated refractions performed within the same session.
      3. The importance of periodic eye health examinations.
   3. If a patient is ineligible for automated refraction under 1.2.2:
      1. Recommend an eye health examination by an appropriately qualified healthcare professional.
      2. Not perform the automated refraction or prepare a dispensing authority unless an appropriately qualified healthcare professional requests preparation of a dispensing authority through automated refraction and this request has been documented in the patient record.
   4. Not charge a fee where automated refraction fails to produce usable information or cannot be performed for reasons set out above.
   5. Ensure any dispensing authority produced includes the patient’s full name, the date of the automated refraction, and the optician’s name, address, license number, and signature.
   6. Retain a copy of the dispensing authority in the patient record, in accordance with the Records Standard.
2. Fitting contact lenses
   An optician must:
   1. Meet the licensure requirements to perform this activity.
3. Vision appliance records
   An optician must:
   1. Provide the patient with a legible copy of the vision appliance record (including a contact lens record, dispensing authority, and/or prescription for a corrective eyeglass lens) free of charge.

The public can expect that optometrists who prescribe vision appliances and/or fit contact lenses are authorized and competent to do so. A member of the public can also expect to receive a copy of their vision appliance record or prescription free of charge.

This appendix applies to all optometrists prescribing vision appliances or fitting contact lenses. It must be read in conjunction with the Ethics and Practice Standards, all of which apply.

1. Prescribing vision appliances
   An optometrist must:
   1. Not state or imply that only an optometrist, qualified medical practitioner, or person acting under delegation or supervision is authorized or qualified to dispense eyeglass lenses and/or contact lenses.
   2. Inform the patient that unless a specific contraindication to contact lens wear is identified:
      1. Contact lenses may be fitted and dispensed using information contained in a prescription for a corrective eyeglass lens.
      2. Contact lenses may be fitted by optometrists, qualified medical practitioners (and those to whom they have appropriately delegated this health service), and contact lens fitters (i.e., opticians).
2. Vision appliance records
   An optometrist must:
   1. Provide the patient with a legible copy of the vision appliance record (including a contact lens record, dispensing authority, and/or prescription for a corrective eyeglass lens) free of charge.