Scope of Practice and Permitted Procedures
What this domain tests
Scope questions rarely ask for a definition. They ask whether a specific act, performed on a specific patient, sits inside Idaho optometric practice - and what to do when it does not.
The core grant
- The Act authorizes examination, diagnosis, treatment, and management of the visual system and ocular adnexa, including refraction and fitting of spectacles and contact lenses.
- Optometrists may use and prescribe diagnostic and therapeutic pharmaceutical agents as authorized by the Act and Board rules. Controlled substances additionally require federal DEA registration and compliance with Idaho prescription monitoring requirements.
- Non-surgical office procedures that fall within diagnosis and treatment of the eye and adnexa - removal of a superficial conjunctival foreign body or epilation of misdirected lashes, for example - are ordinarily within scope.
- Authority is not unlimited: the Act does not confer general surgical privileges, and a procedure the Board has not authorized is outside scope regardless of the optometrist's training.
Judgment, referral, delegation
- Scope is condition-specific. The same act may be within scope for one presentation and require referral for another.
- Referral and co-management duties arise when a condition exceeds the optometrist's competence or statutory authority.
- Unlicensed staff may perform only delegated tasks that do not require optometric judgment.
Worked example
An optometrist diagnoses anterior uveitis and starts topical steroid and cycloplegic therapy. The reasoning: the statute authorizes pharmaceutical treatment of ocular disease; the diagnosis is documented; a treatment plan and follow-up interval are recorded; and the patient is referred if the response is atypical or the condition exceeds the optometrist's authority.
Traps
- Assuming a DEA registration widens scope.
- Assuming a technique taught at a continuing education course is thereby authorized.
- Delegating refraction or judgment-based testing to technicians without the required supervision.