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Key facts for optometrists and opticians
- Regulators
- e.g. College of Optometrists of Ontario, College of Opticians of Ontario, College of Health and Care Professionals of BC, Alberta College of Optometrists, College of Opticians of Alberta, Quebec's two ordres
- Law
- Ontario RHPA 1991, Optometry Act 1991 and Opticianry Act 1991; BC HPOA (from April 1, 2026); Alberta Health Professions Act; Quebec Professional Code
- Key Ontario rule
- Prescribing or dispensing eyeglasses, contact lenses or subnormal vision devices is a controlled act under the RHPA
- Typical triggers
- Missed eye disease, dispensing disputes, prescription or record requests, sales and billing practices, conduct
- Possible outcomes
- No action, advice, caution, education or remediation, undertaking, referral to discipline
- First step
- Contact your liability insurer and preserve the full record before you reply
Start here: the core remediation set for eye care professionals
Core course 1Ethics
Ethics for Optometrists and Opticians
Ethics where clinical care meets retail: honest prescriptions and sales, scope of practice, referral, records and college complaints.
Core course 2Professionalism
Professional Standards for Optometrists and Opticians
Professional standards for Canadian optometrists and opticians: integrity under retail pressure, scope of practice, red-flag referral, consent, role-specific records and responding to a college complaint.
Which one do I need?
| Compare | Ethics for Optometrists and Opticians | Professional Standards for Optometrists and Opticians |
|---|---|---|
| Focus | Values, reasoning and ethical dilemmas | Conduct, standards, scope, records and accountability |
| The question it answers | What is the right thing to do here, and why? | What do my standards require, and how do I show it? |
| Choose it when | A decision, a dilemma or your judgement is in question | Behaviour, systems, scope of practice or records are in question |
Not sure? Many concerns and most CPD plans need both: take them together for a complete picture.
Eight courses make up the core set for optometrists and opticians. The two profession-specific courses are written for both roles and point out where the clinical examining role and the dispensing role carry different responsibilities.
Ethics and Ethical Standards for Optometrists and Opticians covers the reasoning behind decisions in a setting that is both clinical and commercial: the core principles, provincial college regulation, scope of practice, communication and consent about prescriptions and options, documentation, and separate decision-making approaches for optometrists in the examining room and opticians at the dispensing table, especially when clinical duty and sales pressure point in different directions. Professionalism and Professional Standards for Optometrists and Opticians covers conduct: integrity and accountability, boundary crossings and violations, the absolute prohibition on sexual relationships with patients, scope risks, difficult conversations, documentation responsibilities in each role, high-risk referral decisions and responding to errors.
- How to Deal with a Complaint or Investigation: the college process and a measured response.
- Module on Insight: understanding the patient's view of what went wrong.
- Module on Reflection: a reflective statement that shows learning rather than defensiveness.
- Module on Remediation: a plan with goals and evidence.
- Ensuring a Mistake or Misconduct Is Not Repeated: recall, referral and dispensing safeguards.
- Rebuilding Trust: with patients, colleagues, employers and the college.
Each course is two hours, CA$95, online and self-paced, with a 10-question assessment (80% to pass) and a certificate of completion that includes your reflective account.
Core setComplete the set with these
Missed eye disease, referral and recall
The most serious clinical complaints about optometrists concern conditions that were present but not detected or not referred in time: glaucoma, retinal detachment, diabetic or hypertensive changes, or signs of a neurological problem. Colleges look at whether the examination was appropriate to the patient's symptoms and risk, whether findings were recorded, whether the patient was told what was found and what to do, and whether referral and recall were arranged and followed up.
Opticians can face the same kind of concern when a patient reports symptoms at the dispensing table that should prompt a referral back to an optometrist or physician. The clinical competence course covers clinical reasoning and responding to warning signs, the documentation course covers what a defensible record shows, and teamwork covers referral and handover.
RecommendedStart with these
Further relevantAdd if they fit the concern
Dispensing, prescriptions and scope
Dispensing concerns include eyewear or contact lenses supplied without a valid or current prescription, lenses that do not match the prescription, poor fitting or follow-up for contact lenses, and disputes about who may perform which tasks. In Ontario, prescribing or dispensing eyeglasses, contact lenses or subnormal vision devices (other than simple magnifiers) is a controlled act, so who does it, and under what authority, is a legal question as well as a professional one. Scope rules for refraction, contact lens fitting, delegation to staff and online dispensing differ by province, so read your own college's standards alongside the courses.
Patients are also entitled to information and records about their own care. Refusing or delaying a prescription or record to keep a sale is a frequent source of complaints.
RecommendedStart with these
Further relevantAdd if they fit the concern
Sales pressure, billing and insurance receipts
Eye care is often delivered in a retail setting, and many complaints arise from the sale rather than the care: products recommended for commission rather than need, coatings or upgrades the patient did not understand, pressure to buy on the day, and prices not explained. Billing concerns include public plan claims for examinations that did not meet the program's requirements and insurance receipts that misstate what was supplied, when, or at what price. Colleges treat the latter as dishonesty.
The ethics course addresses decision-making under commercial pressure directly. Pair it with the financial integrity course and the probity course.
RecommendedStart with these
Further relevantAdd if they fit the concern
Records, privacy and consent
Records in eye care include examination findings, images, prescriptions, dispensing details and the communication that went with them. Colleges expect them to be complete, legible, timely and kept for the required period, and they routinely request them during an investigation. Privacy concerns include images or records shared without consent, records left accessible in a retail space, and marketing to patients using their health information.
Consent is not only for clinical tests. Patients should understand the options, the costs and what is included before they agree. The documentation, confidentiality and consent courses form the core of this group.
RecommendedStart with these
Further relevantAdd if they fit the concern
Boundaries and conduct
Eye examinations and fittings involve close physical proximity, often in a darkened room, so boundary standards matter. Sexual or intimate relationships with patients are prohibited, and the RHPA sexual abuse provisions apply in full in Ontario. Other conduct concerns include inappropriate comments, rough handling during a fitting, disrespectful treatment of staff, and conflict with other eye care professionals in the same practice.
Start with the professionalism course for optometrists and opticians, then add boundaries, communication or teamwork depending on what was raised.
RecommendedStart with these
Further relevantAdd if they fit the concern
Match the concern to a course
The concerns that most often lead to complaints and investigations, how they are viewed, and the courses that address each one.
Glaucoma, retinal or other disease missed
Committees look at whether testing matched the patient's symptoms and risk, whether findings were recorded and whether referral and recall happened.
Patient not told about a finding
Patients should understand what was found, what it means and what to do next; the record should show the conversation.
Eyewear or lenses supplied without a valid prescription
In Ontario dispensing is a controlled act; elsewhere provincial rules apply, and colleges expect a current, valid prescription.
Prescription or records withheld
Delaying or refusing a patient's prescription or records to protect a sale is a common complaint and a professional concern.
Upselling or unexplained charges
Recommendations should be based on need, with options and prices explained before the patient agrees.
Insurance receipt does not match what was supplied
Misstating the product, date or price on a receipt is treated as dishonesty by colleges and may be audited by insurers.
Task done outside scope or improperly delegated
Scope and delegation rules differ by province and between optometrists, opticians and unregulated staff.
Inappropriate contact or comments during an examination
Close proximity in a darkened room calls for clear explanation and strict boundaries; sexual relationships with patients are prohibited.
How a complaint about an optometrist or optician is handled
Optometry and opticianry are regulated separately in most provinces, and in BC the two professions now share a multi-profession college.
Ontario: two colleges
Optometrists are regulated by the College of Optometrists of Ontario and opticians by the College of Opticians of Ontario. Both follow the Health Professions Procedural Code: a panel of the Inquiries, Complaints and Reports Committee reviews a complaint or registrar's investigation and can take no action, give advice, require a caution, require a specified continuing education or remediation program, accept an undertaking, inquire into health, or refer allegations to the Discipline Committee. Complaint decisions can be reviewed by the Health Professions Appeal and Review Board.
British Columbia: CHCPBC
Since June 28, 2024, optometrists and opticians in BC have been regulated by the College of Health and Care Professionals of BC, alongside dietitians, occupational therapists, physical therapists, psychologists and speech and hearing professionals. From April 1, 2026 the college operates under the Health Professions and Occupations Act, with discipline in serious cases decided by independent panels.
Alberta
Optometrists are regulated by the Alberta College of Optometrists and opticians by the College of Opticians of Alberta. Under the Health Professions Act, a complaints director can resolve a complaint, investigate, dismiss it or refer it to a hearing tribunal, and dismissals can be reviewed by a complaint review committee.
Quebec
Optometrists belong to the Ordre des optométristes du Québec and dispensing opticians to the Ordre des opticiens d'ordonnances du Québec. Each ordre's syndic investigates under the Professional Code and can file a complaint before the disciplinary council, propose conciliation or decide not to proceed.
Employers and insurers
Many optometrists and opticians work for retail chains or in practices they do not own. An employer's own review can run alongside the college matter, and insurers may audit receipts separately. Your professional liability insurer is the first call when a complaint arrives.
Your province: who handles a concern
Optometrists and opticians usually have separate regulators, except in British Columbia, where both now sit in one multi-profession college. Find your province below, and check the scope rules of your own college, because they differ between provinces.
| Province or territory | Optometrists | Opticians | Law and complaint route |
|---|---|---|---|
| Ontario | College of Optometrists of Ontario | College of Opticians of Ontario | Optometry Act, 1991 and Opticianry Act, 1991, with the Health Professions Procedural Code under the Regulated Health Professions Act, 1991. An Inquiries, Complaints and Reports Committee (ICRC) panel screens complaints and reports and can give advice, require a caution, require a SCERP or accept an undertaking; HPARB can review complaint decisions. |
| British Columbia | College of Health and Care Professionals of BC | College of Health and Care Professionals of BC | Health Professions and Occupations Act, in force since 1 April 2026. The college investigates; serious matters go to independent discipline panels rather than to the college. |
| Alberta | Alberta College of Optometrists | College of Opticians of Alberta | Health Professions Act. A complaints director decides how a complaint is handled, from resolution to investigation; serious matters go to a hearing tribunal. |
| Quebec | Ordre des optométristes du Québec | Ordre des opticiens d'ordonnances du Québec | Professional Code. The syndic investigates and may file a complaint before the disciplinary council; appeals go to the Tribunal des professions. |
| Saskatchewan | Saskatchewan Association of Optometrists | Saskatchewan College of Opticians | Saskatchewan statutes for each profession. |
| Manitoba | Manitoba Association of Optometrists | Opticians of Manitoba | Manitoba statutes for each profession. |
| Nova Scotia | Nova Scotia College of Optometrists | Nova Scotia College of Dispensing Opticians | Regulated Health Professions Act (2023), which applies in full to each profession once its regulator has migrated to it. Optometry and opticianry are in the last group to move. |
| New Brunswick | New Brunswick Association of Optometrists | Check the provincial government's list of regulators | Its own provincial statute for the profession, with complaint, investigation and hearing stages. |
| Prince Edward Island | Prince Edward Island College of Optometrists | Check the provincial government's list of regulators | Its own provincial statute for the profession, with complaint, investigation and hearing stages. |
| Newfoundland and Labrador | Newfoundland and Labrador College of Optometrists | Dispensing Opticians Board of Newfoundland and Labrador | Its own provincial statute for the profession, with complaint, investigation and hearing stages. |
For the territories, check with the territorial government where you practise.
Names and processes change: Nova Scotia is moving its health professions under one Act, and British Columbia's new Act came into force on 1 April 2026. Always confirm on your own regulator's website before you rely on a summary, including ours.
What the college looks for in your response
- Clinical reasoning: was the examination appropriate to the patient's symptoms and risk, and is that recorded?
- Referral and follow-up: was the patient told what was found, referred where needed and recalled?
- Scope: did each person act within their role and authority?
- Honest dealing: were options and prices explained, and do receipts and claims match what was supplied?
- Insight: do you understand why the patient lost confidence, even if you disagree with their account?
- Changes made: new recall systems, referral checklists, consent forms or dispensing checks.
Remediation in practice: choosing, reflecting and presenting your evidence
Whether your matter sits with an ICRC panel at either Ontario college, a complaints director in Alberta, a CHCPBC investigation in BC or the syndic of a Quebec ordre, the people deciding it ask the same practical question: has this practitioner understood the concern and done enough, in a way someone else can check, to make a repeat unlikely? Remediation is how you answer it. This is what that usually means in practice.
What decision-makers typically look for
- Learning that matches the concern, not a general CPD list: the topic in the letter, the standard that applies and the risk it created.
- Insight in your own words: what happened, why it mattered to the patient, and your part in it, without minimizing or blaming others.
- A change in practice that is specific, dated and still in place, rather than an intention.
- Verification: certificates, audits, procedures and feedback from someone who has seen you work since.
- Honesty and timing: learning described accurately, completed before you rely on it, and a response sent on time.
Choosing courses for the concern
Copy each allegation from the letter into a list. Beside each one, note the standard it engages and the course that addresses it, using the concern table on this page. Add the core set: the complaint course and the insight course first, then reflection and remediation. Two to four targeted courses plus the core set usually tell a clearer story than a long list of unrelated certificates. If an undertaking, a SCERP or an order already names the education required, follow its terms and ask the college before you add anything to it.
Writing your reflective account
Each course ends with a guided reflective account that is printed on your certificate. A credible reflection usually covers, in this order:
- What happened, in factual terms and without patient identifiers.
- The standard that applied, named from your own college's code or practice standard.
- The impact on the patient, the team and trust in the profession.
- Your part, stated plainly, with system factors explained but not used as an excuse.
- What you learned from this course, in specifics rather than general statements.
- What you now do differently, since when, and how someone could confirm it.
Presenting your evidence
| Item | What it shows | Practical tip |
|---|---|---|
| Short covering summary | How each item answers each concern | One page, one line per allegation, written with your liability insurer or lawyer |
| Certificates of completion | That defined learning took place and was assessed | Keep the dates; show learning completed after the events, not promised |
| Reflective accounts | Insight and the link to your practice | Revise before submitting; a reflection written in the first days can read as defensive |
| Practice evidence | That the change is real and has lasted | For example a referral log with urgency and follow-up, an audit of your own records, a dispensing or verification checklist, updated pricing and receipt practices, and feedback from a supervisor or peer |
| An index | That the file is complete and easy to follow | Number each item and keep copies of everything you send |
No college, ordre, committee or tribunal has approved or accredited our courses, and we do not say that any of them accepts our certificates. A course cannot guarantee an outcome. Whether learning is relevant or satisfies a requirement is for the decision-maker, so discuss timing and content with your liability insurer or lawyer before you submit anything.
How certificated learning supports your response
Certificates show learning that was completed and assessed, and your reflective account shows how it has changed your examinations, your dispensing or your sales conversations. Many eye care complaints are partly about systems in a practice or store, and the courses help you identify those systems and describe what you have changed.
Only your college can confirm whether a course meets a remediation requirement.
From the college letter to a certificate: five steps
- Get advice. Contact your liability insurer, and tell your employer if your contract requires it. Keep the record intact.
- Match the concern. Referral, dispensing, sales or billing, records or conduct: choose the matching group above.
- Complete the courses. Two to four alongside the core set, at your own pace.
- Write the reflection. Link each course to the concern and describe what you now do differently.
- Share through your adviser. If they agree, include certificates and the reflection with your response.
Support while a complaint is open
- Your liability insurer for legal advice on the college process.
- Your provincial optometric or opticians' association for practice guidance.
- Your family doctor or employee assistance program for stress and wellbeing.
- 9-8-8: call or text 988, any time, if you are in crisis or thinking about suicide.
Start your remediation set
Begin with the eye care ethics and professionalism courses, then add the courses for your concern.
Questions
Are these courses for optometrists, opticians or both?
Both. The ethics and professionalism courses are written for optometrists and opticians together and explain where the examining and dispensing roles carry different responsibilities, for example in documentation and decision-making. The general courses apply to everyone in an eye care practice.
Which courses should I take after a complaint about a missed referral?
Start with the eye care professionalism course, the clinical competence course and the documentation course, with How to Deal with a Complaint or Investigation and the insight module. Add teamwork for referral and handover. Your reflection should describe the recall and referral systems you now use.
Do the College of Optometrists of Ontario or the College of Opticians accept your certificates?
No college approves or accredits our courses, and we do not claim otherwise. When a committee considers your response, it looks at what you have learned and changed. A certificate with a reflection is evidence of that. If you have been given specific remediation, ask the college whether a course meets it.
Who regulates optometrists and opticians in BC now?
Since June 28, 2024, both have been regulated by the College of Health and Care Professionals of BC. From April 1, 2026 the college operates under the Health Professions and Occupations Act, which moved discipline decisions in serious cases to independent panels.
My employer sets sales targets. Will the college take that into account?
Colleges recognize commercial pressure as context, but they hold each registrant responsible for professional judgment. Explain the pressure honestly and show how you now make and document recommendations based on need. The ethics course for optometrists and opticians addresses this situation directly.
Can I refuse to give a patient their prescription until they buy glasses?
Withholding a prescription or record to secure a sale is a common source of complaints and is inconsistent with patients' rights to information about their own care. Check your college's standard for the exact rules in your province. The ethics and communication courses cover how to handle the conversation.
Do your courses teach refraction or contact lens fitting?
No. They cover the professional side of practice: ethics, consent, records, scope, communication, billing integrity and patient safety. If a college requires clinical upgrading in a particular skill, you will need hands-on training from an appropriate provider for that part.
I work in a store owned by someone else. Who is responsible for a complaint?
The college looks at your own professional conduct whoever owns the business. The owner's policies matter as context, and the employer may run its own process, but your professional obligations are personal. Your liability insurer can advise on how to respond to both.
Can I take courses before I respond to the college?
Yes. Many registrants start as soon as they receive the letter, because the learning helps them write a better response and shows engagement with the concern. Discuss with your adviser how and when to mention it.
Do these hours count for my college's continuing education requirements?
Relevant learning can usually be recorded, but each college sets its own categories and credit rules. We do not claim any credit value. Each certificate states two hours (estimated) so you can record the time accurately.
A patient says I was rude during a contact lens fitting. Where should I start?
Start with the eye care professionalism course and the communication course, and add rebuilding trust. Your reflection should show that you understand how the patient experienced the appointment, and describe how you now explain each step and check the patient is comfortable.
Is a receipt adjustment for a patient's insurance really a college matter?
Yes. A receipt that misstates the product, date or price is a false document, even if the patient asked for it and even if the amount was small. Colleges treat it as dishonesty. Take the financial integrity and probity courses, and take advice before you respond.
How should I present my courses and reflection to the decision-maker?
As part of a short, indexed evidence file: a one-page summary linking each concern to what you have done, your certificates, the reflective account from each course, and evidence that your practice has changed, such as an audit, a revised procedure or feedback from a supervisor. Agree the content and timing with your liability insurer or lawyer first.
Official sources
Checked October 2026. Rules and processes change, so confirm the current position with the official source. This page is general information, not legal advice.
- Ontario e-Laws: Regulated Health Professions Act, 1991 (including the Health Professions Procedural Code)
- Ontario e-Laws: Opticianry Act, 1991
- Government of British Columbia: health profession college amalgamations (June 28, 2024)
- College of Physicians and Surgeons of BC: Health Professions and Occupations Act
- Government of Alberta: Regulated health professions
- Gouvernement du Québec: Recours disciplinaires contre un membre d'un ordre professionnel
- LégisQuébec: Code des professions (chapitre C-26)
- Ontario e-Laws: Personal Health Information Protection Act, 2004
- 9-8-8 Suicide Crisis Helpline
- BC Health Regulators: Regulatory reform and the Health Professions and Occupations Act
- Government of Saskatchewan: Health regulators
- Manitoba Fair Registration Practices Office: Regulator contact list (June 2026)
- Government of Nova Scotia: Health profession regulators
- Government of Nova Scotia: Regulated Health Professions Act overview
- Government of Alberta: Optician registration process
- Government of Prince Edward Island: About the PEI College of Optometrists
- Government of Newfoundland and Labrador: Dispensing Opticians Board of Newfoundland and Labrador annual report
How these courses are built
Official sources only
Every legal and regulatory point comes from primary sources: provincial and territorial health professions statutes, the regulatory colleges' standards and codes, and federal and provincial privacy law. Anything we cannot confirm is left out.
Original, edition by edition
Lessons, scenarios and assessment questions are written by us for each edition separately, then checked for accuracy, teaching quality and fair assessment before publication.
Reviewed when rules change
When a code, standard or law changes, the affected courses are reviewed and updated. Reported errors in legal or regulatory facts are corrected first.