Releasing records to a patient who refuses safe care

Lucy Lain, a 23-year-old patient enters Kara Zorelle’s Optical store. Lucy requests the release of her prescription and contact lens record despite the fact that she hasn’t had her eyes checked since 2013. Kara is hesitant to release the record because she is worried that she might be liable considering Lucy plans to buy her contact lenses online without getting another eye exam.
Kara attempts to educate Lucy telling her about the importance of getting her eyes rechecked and her concern that Lucy could be at risk. Lucy’s eyes have become infected from her improper use of contact lenses in the past, and Kara is concerned that Lucy is not a good candidate for contact lenses. Kara knows if Lucy does not get proper treatment and a new eye test that she will likely come back to the store for further care from Kara. 
Kara is genuinely concerned for her patient and wonders if there is anything more she can do. Knowing that Lucy is internet savvy and has access to an increased level of information online, she wonders what her responsibility is if  the patient refuses to listen to her eye-care professional.
What are the possible issues in this scenario?
Duty of Care
Duty of Care
Kara is met with contradictory standards, as she is obligated to provide the patient with access to their patient records, but as a health care professional, Kara has a duty uphold the contact lens standards. 
The contact lens standards state that each optician must use their professional judgement in re-ordering contact lenses for a pre-existing patient. Although Lucy plans to buy contact lenses online, this standard can apply in Kara’s case. Kara knows that the patient has a history of over-wearing her contact lenses and is at risk. Kara’s duty is to advise the patient it would be in her best vision care and health care interest to get an eye health exam because:
Over-wearing contact lenses can affect Lucy’s long term vision health.
Lucy may not be able to wear contact lenses in the near future if she does not address the issues now.
Kara worries that she will be held accountable for Lucy’s vision care problems if she releases the contact lens record. In order to ensure that Kara has upheld her professional duty, she should outline the potential risks to Lucy verbally and in writing, this would include:
Informing Lucy of the potential negative wearing symptoms.
A reminder of when it would be best for Lucy to return for a scheduled assessment. 
If these risks are outlined in writing and stored in Lucy’s patient file, then there is a record that Kara has done everything in her power to uphold her professional duty as an optician. 
While Kara is right to be concerned about her patient, the best she can do is provide Lucy with all the relevant information she needs to make an informed decision. Even if Lucy chooses not to take Kara’s advice – potentially putting herself at risk – Kara still has to release her patient records. It is still integral that Kara document her interaction with Lucy in case Lucy comes back with further questions and/or problems.