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TITLE 22EXAMINING BOARDS
PART 14TEXAS OPTOMETRY BOARD
CHAPTER 279INTERPRETATIONS
RULE §279.2Contact Lens Prescriptions

(a) Prescription. A prescription for contact lenses is defined as a written order signed by the examining optometrist, therapeutic optometrist or physician, or a written order signed by an optometrist, therapeutic optometrist or physician authorized by the examining doctor to issue the prescription.

  (1) If the prescription is signed by the examining optometrist or therapeutic optometrist, the prescription may be signed electronically, provided that:

    (A) the prescription is electronically signed by the practitioner using a system which electronically replicates the practitioner's manual signature on the written prescription; and

    (B) the security features of the system require the practitioner to authorize each use.

  (2) If the prescription is signed by a doctor other than the examining optometrist, therapeutic optometrist or physician, the prescription must contain:

    (A) the name of the examining doctor; and

    (B) the license number of both the examining doctor and the doctor signing the prescription.

(b) Applicable Law. A contact lens prescription must comply with the requirements of the Texas Optometry Act, Sections 351.005, 351.356, 351.357, 351.359, and 351.607, and the Contact Lens Prescription Act, Sections 353.152, 353.153 and 353.158 and federal law, 15 U.S.C. Sections 7601 - 7610 (Public Law 108-164).

(c) Contents of Prescription. A fully written contact lens prescription must contain all information required to accurately dispense the contact lens, including:

  (1) patient's name;

  (2) the name, postal address, telephone number, and facsimile telephone number of the prescribing optometrist or therapeutic optometrist (required by federal law);

  (3) the date of examination (not including date of follow-up examinations) (required by federal law);

  (4) date the prescription is issued;

  (5) an expiration date of not less than one year, unless a shorter period is medically indicated;

  (6) examining optometrist's signature or authorized signature;

  (7) name of the lens manufacturer, if required to accurately dispense the lens;

  (8) lens brand name, including:

    (A) a statement that brand substitution is permitted if the optometrist intends to authorize a contact lens dispenser to substitute the brand name; and

    (B) name of manufacturer, trade name of private label brand, and, if applicable, trade name of equivalent brand name when the prescribed brand name is not available to the optical industry as a whole, unless the prescribing of a proprietary lens brand is medically indicated;

  (9) lens power;

  (10) lens diameter, unless set by the manufacturer;

  (11) base curve, unless set by the manufacturer; and

  (12) number of lenses and recommended replacement interval.

(d) Release of Prescription, Timing. Regardless of whether the release is requested by the patient, the optometrist or therapeutic optometrist shall release a prescription once the parameters of the prescription are determined. An exception to this requirement exists if the optometrist or therapeutic optometrist determines that because of a medical indication further monitoring is required, and the optometrist or therapeutic optometrist gives the patient a verbal explanation of the reason the prescription is not released and documents in the patient's records a written explanation of the reason.

(e) Release of Prescription, Method. An optometrist or therapeutic optometrist shall issue a prescription by giving or delivering an original signed copy of the prescription to the patient or to another person in accordance with subsection (d) of this section.

(f) Verification of Prescription. An optometrist or therapeutic optometrist shall verify a prescription when a dispenser designated to act on behalf of the patient requests a verification by telephone, facsimile or electronic mail.

(g) Verification Procedure. A dispenser designated to act on behalf of the patient is required to provide the optometrist or therapeutic optometrist with the following information when seeking a verification of a prescription:

  (1) the patient's full name and address;

  (2) contact lens power, manufacturer, base curve or appropriate designation, and diameter, as appropriate;

  (3) quantity of lenses ordered;

  (4) the date on which the patient requests lenses to be ordered or dispensed;

  (5) the date and time of the verification request; and

  (6) the name, telephone number, and facsimile number of a person at the contact lens dispenser's company with whom to discuss the verification.

(h) Verification Requirements. If the format of the verification request allows, the optometrist or therapeutic optometrist, when verifying a prescription, should provide the contact lens dispenser with all of the information required in subsection (c) of this section. An optometrist or therapeutic optometrist who did not perform the examination, may verify a prescription according to subsection (a) of this section, providing to the dispenser the name and license number of the examining doctor if the format of the verification request so allows. Each request for a prescription verification should be recorded in the patient record, including the name of the dispenser, the date verification is requested, number of lenses requested, and response of the optometrist or therapeutic optometrist.

(i) Inaccurate or Invalid Verification. A contact lens dispenser seeking a contact lens prescription verification shall not fill the prescription if an optometrist or therapeutic optometrist informs a dispenser that the contact lens prescription is inaccurate, expired, or otherwise invalid. An optometrist or therapeutic optometrist is required to communicate the basis for the inaccuracy or invalidity of the prescription. If the prescription communicated by the dispenser to the optometrist or therapeutic optometrist is inaccurate or invalid, the optometrist or therapeutic optometrist is required to provide the correct information to the dispenser. A dispenser may dispense lenses without verification if an optometrist or therapeutic optometrist fails to communicate with the dispenser within 8 business hours, or a similar time as defined by the Federal Trade Commission.

(j) Number of Lenses. An optometrist or therapeutic optometrist dispensing contact lenses shall record on the prescription the number of lenses dispensed and return the prescription to the person. If all the contact lenses authorized by the prescription are dispensed by an optometrist or therapeutic optometrist, the following procedure complies with state law and should not be in conflict with federal law: the optometrist or therapeutic optometrist writes on the prescription "All Lenses Dispensed," makes a copy of the prescription to retain in the licensee's records, and returns the original to the person presenting the prescription.

(k) Extension. The Contact Lens Prescription Act requires an optometrist or therapeutic optometrist to authorize, upon request of the patient, a one-time, two-month extension of the contact lens prescription.

(l) Private Labels. The prescribing optometrist or therapeutic optometrist has the authority to specify any and all parameters of an optical prescription for the therapeutic and visual health and welfare of a patient, but the prescription shall not contain restrictions limiting the parameters to private labels not available to the optical industry as a whole, unless the prescribing of a proprietary lens brand is medically indicated. The specifications of the prescription may not be altered without the consent of the prescribing doctor.

(m) Fee. The Contact Lens Prescription Act prohibits an optometrist or therapeutic optometrist from charging the patient a fee in addition to the examination fee and the fitting fee as a condition for giving a contact lens prescription to the patient or verifying a prescription according to subsections (h) and (i) of this section. An optometrist or therapeutic optometrist may not refuse to release a prescription solely because charges assigned or presented for payment to an insurance carrier, health maintenance organization, managed care entity, or similar entity have not been paid by that entity.

(n) Fitting Process. An optometrist or therapeutic optometrist may charge a fitting fee that includes fees for lenses required to be used in the fitting process. The fitting process may include the initial eye examination, an examination to determine the specifications of the contact lenses, and follow-up examinations that are medically necessary. Unless medically necessary, the optometrist or therapeutic optometrist may not require the patient to purchase a quantity of lenses in excess of the lenses the optometrist or therapeutic optometrist was required to purchase to complete the fitting process.

(o) An optometrist or therapeutic optometrist may not sign, or cause to be signed, an ophthalmic lens prescription without first personally examining the eyes for whom the prescription is made pursuant to Section 351.435 of the Optometry Act. An optometrist or therapeutic optometrist is responsible for the prescriptions signed under the practitioner's name even if they are produced by non-clinical staff. Should a licensee discover a prescription for lenses was issued without his knowledge or permission, the licensee shall report it to the Board within seven business days.

(p) The Executive Commissioner of the Health and Human Services Commission and the Executive Director of the Texas Optometry Board may enter into interagency agreements as necessary to implement and enforce this chapter.


Source Note: The provisions of this §279.2 adopted to be effective September 9, 2001, 26 TexReg 6679; amended to be effective December 23, 2001, 26 TexReg 10297; amended to be effective March 28, 2002, 27 TexReg 2237; amended to be effective September 19, 2004, 29 TexReg 8813; amended to be effective December 6, 2005, 30 TexReg 8099; amended to be effective March 4, 2013, 38 TexReg 1362 ; amended to be effective February 12, 2023, 48 TexReg 680

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