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Optometry Act, 1991
Loi de 1991 sur les optométristes

ONTARIO REGULATION 112/11

Designated Drugs and Standards of Practice

Consolidation Period: From February 6, 2017 to the e-Laws currency date.

Last amendment: O. Reg. 17/17.

This Regulation is made in English only.

Part I
Prescriptions

Drugs that may be prescribed

1. For the purposes of paragraph 2.1 of section 4 of the Act, and subject to sections 2, 3 and 4 and Part II of this Regulation, a member may prescribe a drug set out under a category and sub-category heading in Schedule 1.  O. Reg. 112/11, s. 1.

Limitations

2. Where a limitation or a route of administration is indicated with respect to a drug listed in Schedule 1, either in a sub-category heading or with respect to that particular drug, a member shall only prescribe the drug in compliance with the limitation and in accordance with the route of administration specified. O. Reg. 17/17, s. 1.

Training required

3. No member may prescribe any drug unless he or she has successfully completed the relevant training in pharmacology that has been approved by the Council.  O. Reg. 112/11, s. 3.

Recording

4. Every time a member prescribes a drug the member shall record the following in the patient’s health record as that record is required to be kept under section 10 of Ontario Regulation 119/94 (General) made under the Act:

1. Details of the prescription, including the drug prescribed, dosage and route of administration.

2. Details of the counselling provided by the member to or on behalf of the patient respecting the use of the drug prescribed.  O. Reg. 112/11, s. 4.

Non-prescription drugs

5. In the course of engaging in the practice of optometry a member may prescribe any drug that may lawfully be purchased or acquired without a prescription.  O. Reg. 112/11, s. 5.

Part II
Standards of Practice — Glaucoma

Prescribing of antiglaucoma agents

6. It is a standard of practice of the profession that in treating glaucoma a member may only prescribe a drug set out under the category of “Antiglaucoma Agents” in Schedule 1.  O. Reg. 112/11, s. 6.

Open-angle glaucoma

7. (1) Subject to subsection (2) and to section 8, it is a standard of practice of the profession that a member may only treat a patient with glaucoma where the patient has primary open-angle glaucoma the treatment of which is not complicated by either a concurrent medical condition or a potentially interacting pharmacological treatment.  O. Reg. 112/11, s. 7 (1).

(2) It is a standard of practice of the profession that a member may only treat a patient having open-angle glaucoma, the treatment of which is complicated by either a concurrent medical condition or a potentially interacting pharmacological treatment, in collaboration with a physician with whom the member has established a co-management model of care for that patient and who is,

(a) certified by the Royal College of Physicians and Surgeons of Canada as a specialist in ophthalmology; or

(b) formally recognized in writing by the College of Physicians and Surgeons of Ontario as a specialist in ophthalmology.  O. Reg. 112/11, s. 7 (2).

Referral to physician or hospital

8. (1) Subject to subsections (2) and (3), it is a standard of practice of the profession that a member shall immediately refer a patient having a form of glaucoma other than primary open-angle glaucoma to a physician or to a hospital.  O. Reg. 112/11, s. 8 (1).

(2) It is a standard of practice of the profession that a member may initiate treatment for a patient having angle-closure glaucoma only in an emergency and where no physician is available to treat the patient.  O. Reg. 112/11, s. 8 (2).

(3) It is a standard of practice of the profession that a member shall immediately refer any patient being treated in accordance with subsection (2) to a physician or hospital once the emergency no longer exists or once a physician becomes available, whichever comes first.  O. Reg. 112/11, s. 8 (3).

(4) In this section,

“hospital” means a hospital within the meaning of the Public Hospitals Act.  O. Reg. 112/11, s. 8 (4).

9. Omitted (provides for coming into force of provisions of this Regulation).  O. Reg. 112/11, s. 9.

SCHEDULE 1

ANTI-INFECTIVE AGENTS

Antibacterials (topical)

azithromycin

besifloxacin 

ciprofloxacin

erythromycin

framycetin 

fusidic acid 

gatifloxacin

gentamicin

moxifloxacin 

ofloxacin

polymyxin B/gramicidin/neomycin

polymyxin B/neomycin/ bacitracin

polymyxin B/trimethoprim 

sulfacetamide

tetracycline

tobramycin 

Antifungals (topical)

natamycin

Antivirals (topical)

trifluridine

Acyclovir

Antibacterials (oral) – for corneal or eyelid infections only and for a duration not exceeding 14 days

amoxicillin

amoxicillin/clavulanic acid

azithromycin 

cephalexin

ciprofloxacin 

clarithromycin

clindamycin

cloxacillin

doxycycline

erythromycin 

levofloxacin 

minocycline

moxifloxacin

tetracycline

Antivirals (oral) – for corneal or eyelid infections only

acyclovir 

famciclovir

valacyclovir

ANTI-INFLAMMATORY AGENTS

Corticosteroids (topical)

dexamethasone

difluprednate

fluorometholone

loteprednol

prednisolone

rimexolone

Corticosteroids (topical) – for the purpose of treating conditions of the eye and adnexa

triamcinolone

Immunomodulators (topical)

cyclosporine

Nonsteroidal anti-inflammatory agents (topical)

bromfenac

diclofenac

ketorolac

nepafenac

ANTI-INFECTIVE/ANTI-INFLAMMATORY AGENTS

Antibacterials /corticosteroids (topical)

framycetin/gramicidin/dexamethasone

gentamicin/betamethasone

neomycin/fluorometholone

neomycin/polymyxin B/dexamethasone

neomycin/bacitracin/polymyxin B/hydrocortisone

sulfacetamide/prednisolone

tobramycin/dexamethasone

MYDRIATICS

Mydriatics (topical)

atropine 

cyclopentolate

homatropine

tropicamide

ANTI-ALLERGIC AGENTS

Antiallergic agents (topical)

bepotastine

emedastine

ketotifen

levocabastine

lodoxamide

nedocromil

olopatadine

tacrolimus – for the purpose of treating conditions of the eye and adnexa and for a duration not exceeding 42 days

ANTIGLAUCOMA AGENTS

β-Adrenergic blocking agents (topical)

betaxolol

levobunolol

timolol

Carbonic anhydrase inhibitors (topical)

brinzolamide

dorzolamide

Miotics (topical)

carbachol

pilocarpine

Prostaglandin analogs (topical)

bimatoprost 

latanoprost 

tafluprost

travoprost

α-Adrenergic agonists (topical)

apraclonidine

brimonidine 

α-Adrenergic agonists/β-adrenergic blocking agents (topical)

brimonidine/timolol

Carbonic anhydrase inhibitors/β-adrenergic blocking agents (topical)

brinzolamide/timolol

dorzolamide/timolol

Prostaglandin analogs/β-adrenergic blocking agents (topical)

latanoprost/timolol

travoprost/timolol

Carbonic anhydrase inhibitors (oral) – to lower intraocular pressure only and a member shall immediately refer the patient to a physician or to a hospital

acetazolamide

SECRETAGOGUES

Secretagogues (oral) – for Sjögren’s syndrome only and only in collaboration with a physician with whom the member has established a co-management model of care

pilocarpine

O. Reg. 112/11, Sched. 1; O. Reg. 17/17, s. 2.