The guideline covers patient assessment, diagnosis, management, referral, and follow-up across the lifespan.

1. Purpose and Scope

This clinical guideline outlines the standards of optometry practice to ensure safe, ethical, and evidence-based eye care. It applies to optometrists working in primary, secondary, and tertiary eye care settings, including hospitals, clinics, community programs, and academic institutions. The guideline covers patient assessment, diagnosis, management, referral, and follow-up across the lifespan.

2. Professional Responsibilities

Optometrists shall:

• Practice within their scope of training, licensure, and competency
• Maintain patient-centered, ethical, and culturally sensitive care
• Adhere to infection control, patient safety, and confidentiality standards
• Engage in continuous professional development (CPD) and evidence-based practice

3. Patient Assessment and Examination

A comprehensive optometric examination should include:

3.1 Case History

• Presenting complaints and visual symptoms
• Ocular, medical, drug, occupational, and family history
• Lifestyle and visual demand assessment

3.2 Visual Assessment

• Distance and near visual acuity
• Objective and subjective refraction
• Binocular vision and accommodation assessment
• Color vision and contrast sensitivity (when indicated)

3.3 Ocular Health Evaluation

• External eye examination
• Slit-lamp biomicroscopy
• Intraocular pressure measurement
• Fundus examination (direct/indirect ophthalmoscopy or fundus imaging)

4. Diagnosis and Clinical Decision-Making

• Establish diagnoses based on clinical findings and validated protocols
• Differentiate refractive, binocular, ocular disease, and neuro-visual conditions
• Document findings clearly and accurately in patient records

5. Management and Treatment

Optometrists may provide:

• Spectacle and contact lens prescription and fitting
• Low vision assessment and rehabilitation
• Vision therapy and binocular vision management (where trained)
• Dry eye evaluation and non-pharmacological management
• Patient education, counseling, and preventive eye care advice

6. Referral and Co-Management

Timely referral is mandatory when:

• Ocular pathology exceeds optometric scope
• Medical or surgical intervention is required
• Red-flag signs (sudden vision loss, severe pain, trauma) are present

Optometrists should collaborate with:

• Ophthalmologists
• Primary care physicians
• Psychologists, occupational therapists, and rehabilitation specialists (especially in low vision care)

7. Low Vision and Special Populations

• Conduct functional vision assessments
• Prescribe optical and non-optical low vision aids
• Address psychosocial impact and screen for depression where appropriate
• Provide services for pediatric, geriatric, and special-needs populations

8. Infection Control and Patient Safety

• Follow standard precautions and equipment disinfection protocols
• Ensure calibration and maintenance of instruments
• Practice safe contact lens hygiene education and monitoring

9. Documentation and Record Keeping

• Maintain accurate, legible, and confidential patient records
• Document consent, findings, management plans, and follow-up instructions
• Use electronic medical records where available

10. Ethics, Legal, and Professional Conduct

Optometrists must:

• Obtain informed consent
• Respect patient autonomy and confidentiality
• Avoid conflicts of interest
• Comply with national regulatory and professional body standards

11. Quality Assurance and Audit

• Participate in clinical audits and peer review
• Monitor patient outcomes and service quality
• Implement corrective actions where needed

12. Continuing Professional Development

• Engage in lifelong learning
• Stay updated with advances in optometry and vision science
• Participate in research, teaching, or professional service activities

Conclusion:

Adherence to this Clinical Guideline of Optometry Practice promotes high-quality, safe, and ethical eye care. It supports optometrists in delivering comprehensive services, strengthening interdisciplinary collaboration, and improving visual and functional outcomes for patients.