An optometrist shall notify the optometry board office within seventy-two hours of the occurrence of any instance of a clinically significant drug-induced side effect in a patient resulting from the optometrist administering, employing, applying, or furnishing such topical ocular or therapeutic pharmaceutical agent to or for the patient.
A report form, which will be provided by the optometry board to the reporting optometrist, shall be completed and forwarded to the optometry board office within ten days of receipt to provide the required information to comply with section 4725.31 of the Revised Code. The report form will include, but is not limited to, the presenting problem, diagnosis, agent administered, benefits achieved, problems encountered, and the action taken on the part of the administering optometrist to alleviate the patient problem. This report will not include the name or any other identifying information on the patient. This report will not be filed in the reporting optometrist's file but in a separate file designated by the board to retain this information for a period of two years.
A clinically significant drug-induced side effect means an unexpected reaction by a person resulting from topical ocular or therapeutic pharmaceutical agents administered by an optometrist which occurs within twenty four hours after the drug is administered and requires either referral to a medical doctor for treatment or hospitalization of the individual.
Failure to comply with all or part of this reporting procedure constitutes "dishonesty or unprofessional conduct" as that phrase is used in section 4725.19 of the Revised Code.