(1) Minimum Procedures for Comprehensive Eye Examination. Except when sound professional judgement dictates otherwise, a comprehensive eye examination shall include the following minimum procedures, the findings of which shall be clearly and legibly recorded in the patient's case record:

1. (a) an adequate medical and ocular history;
2. (b) measurement of the visual acuity for each eye, for both distance and close range;
3. (c) an examination for the health of the external ocular adnexa, utilizing at least magnification or microscopy;
4. (d) an examination of the health of the internal ocular media, utilizing at least ophthalmoscopy and microscopy or magnification;
5. (e) an objective refractive measurement of each eye;
6. (f) an evaluation of the extraocular muscle function, including motility studies and binocular status;
7. (g) an examination of the peripheral fields;
8. (h) measurements of intraocular pressure; and
9. (i) any other tests and procedures that may be indicated by the patient's medical or ocular history or objective signs or symptoms discovered during the examination.

(2) Minimum Procedures for Contact Lens Evaluations.

1. (a) Initial Evaluations. In the initial diagnosis, treatment and management of a contact lens patient, except when sound professional judgment dictates otherwise, the following minimum procedures shall be performed, the findings of which shall be clearly and legibly recorded in the patient's case record:

   1. 1. all minimum procedures for comprehensive eye examinations as set forth in 246 CMR 3.01(1);
   2. 2. a biomicroscopic examination of the cornea, the palpebral and bulbar conjunctiva, the tear film and related external adnexa;
   3. 3. measurements of the curvature of the cornea;
   4. 4. administration of adjuvants, including diagnostic stains if indicated;
   5. 5. an evaluation of the visual acuity obtained in each eye with the contact lenses, at

   distance and, when appropriate, at intermediate and at near range; 6. an evaluation of the fit of the lenses; and 7. establishment of a date for a subsequent evaluation for the purpose of finalizing the prescription, unless such examination is contraindicated.

2. (b) Subsequent Evaluations. In a subsequent evaluation of a contact lens patient, the following minimum procedures shall be performed, the findings of which shall be clearly and legibly recorded on the patient's case record:

   1. 1. A biomicroscopic examination of the cornea, the palpebral and bulbar conjunctiva, the tear film and related external adnexa;
   2. 2. An evaluation of the visual acuity obtained in each eye with the contact lenses, at distance and, when appropriate, at intermediate and at near range;
   3. 3. An evaluation of the fit of the lenses; and
   4. 4. Establishment of a date for the next examination.