Scope of Practice and Prescriptive Authority
This domain tests the boundary between optometric care and general medical practice, plus the conditions for lawful prescribing in Michigan.
Core rules
- Michigan optometrists examine, diagnose, and treat conditions of the visual system, prescribe corrective lenses and contact lenses, and use diagnostic and therapeutic pharmaceutical agents within optometric scope.
- Prescriptive authority is not a general medical license. It is limited to agents and conditions within optometry and the standard of care.
- Controlled-substance prescribing, where permitted, requires DEA registration and compliance with Michigan’s prescription-monitoring rules; non-controlled drugs still require a patient evaluation and documented rationale.
- Refer or co-manage when findings exceed scope, competence, or equipment.
Worked example
A patient presents with a red eye, mucopurulent discharge, and normal vision. The optometrist diagnoses bacterial conjunctivitis and prescribes a topical antibiotic. That is within scope: the condition is ocular, the drug is appropriate, and findings are documented. If the patient instead has proptosis, pain with eye movement, fever, or reduced vision, the optometrist should suspect orbital cellulitis and refer urgently rather than simply prescribe another drop.
Traps that cost marks
- Prescribing for self or family without a proper patient relationship.
- Refilling or phoning in medications without an evaluation and record.
- Assuming oral or controlled-substance authority is unlimited.
- Ignoring pregnancy, renal, allergy, or interaction risks.
- Failing to refer when “within scope” does not mean “within this licensee’s competence.”