A. Privileges granted to optometrists shall be on the basis of their licensure, training, experience, demonstrated competence, judgment and current credentials as determined by the Board. Scope and extent of their medical and surgical privileges shall be specifically delineated and granted in the same manner as all other medical and surgical procedures.

B. Optometrists may consult on inpatients, see outpatients in the emergency room or outpatient departments, and may admit patients to the hospital in conjunction with a medical physician in accordance with the provisions of N.C. G.S. 131E-86. The names of both the optometrists and medical physician are required for the part of the history and physical and treatment plan related to the optometric care of the patient. A physician will be responsible for the completion of the history and physical appropriate to the service on which the patient is admitted and determine if consultation is needed, the overall risk assessment, the effect of treatment on the health of the patient, and will have the final authority on all treatments carried out in the hospital. The physician shall record in the patient's medical record his/her willingness to provide such care. Optometrists granted clinical privileges shall be assigned to the Department of Family Practice.

C. Optometrists may prescribe medication and write orders for the evaluation and treatment of conditions of the eye and its related structures within the limits of their license and privileges granted pursuant to these by-laws. Systemic conditions or any conditions involving other organ systems which may present signs and symptoms of the eyes should be evaluated in conjunction with a medical physician.

• 1. Utilize the hospital laboratory facilities for routine laboratory studies such as glucose tolerance, thyroid, etc.
• 2. Utilize the hospital radiology and other imaging facilities for X-ray or other studies in case of suspected intraocular foreign bodies, orbital fractures, tumors, retinal detachments, choridal neovascularization, etc.
• 3. Utilize the hospital laboratory facilities for routine cultures and cell cytology.
• 4. When patients of staff optometrists are hospitalized under the care of another physician for treatment of a problem unrelated to their eyes and develops an eye problem while in the hospital, they would have the privilege of seeing their patients for the eye problem only during that hospitalization.
• 5. When their patients are seen in the emergency room for an eye injury or other ophthalmic problem, the patient would be referred to them for outpatient follow-up on the same basis as the patient of any other doctor in the community.
• 6. They would have the right to provide consultation services either in the emergency room or hospital for patients with ophthalmic problems. In this regard, they should be willing to provide consults for patients under their care at that time and be willing to serve on a rotating basis to take calls of this type for the convenience of the hospital staff.
• 7. The right to admit patients for ocular emergencies provided that they have the prior concurrence or consultation of a medical doctor who is a member of the hospital staff.
• 8. Privileges are limited to those activities which optometrists are authorized to perform pursuant to Article 6 of Chapter 90 of the North Carolina General Statues and Chapter 42 of the NCAC.