The College of Optometrists

Contact lens check-ups

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Sub-sections

Key points

  • When you examine a contact lens wearer you should carry out all the required key assessments, record your findings and communicate them to the patient.
  • You should give the same level of care to patients wearing powered or zero powered lenses.
  • If you are asked to re-issue or revalidate a patient’s contact lens specification you are responsible for the specification and should check the lenses they are wearing.

Principles of contact lens check-ups

A345
When examining a wearer of contact lenses you must regularly assess the general ocular status of the patient or receive assurances that another practitioner is making such assessments.
A346
If you carry out a contact lens check-up and re-issue the patient’s specification for the same or different contact lenses you are considered to be fitting the patient with contact lenses.123 In this situation you must not fit a patient with contact lenses unless they have an up-to-date spectacle prescription.124
A347
You should give patients wearing powered or zero powered contact lenses the same degree of care. 

References

123 Opticians Act 1989 s25(9)(a)
124 Opticians Act 1989 s25(1A)

Examining contact lens wearers

A348
When you examine a contact lens wearer you must conduct an adequate assessment.125 You should: 
  1. assess the patient’s wearing patterns and wearing times
  2. identify any symptoms they experience while wearing lenses or any signs noted during wear or after lens removal
  3. record the patient’s current care system
  4. measure the refractive status and acuities with the lens on the patient’s eye, including astigmatic elements as appropriate
  5. assess the lens fit and the condition of the lenses themselves
  6. on removal of the lenses, examine the eye and adnexa as required to detect any contact lens related adverse effects. This will include the use of appropriate topical drugs and diagnostic agents
  7. include additional tests which are indicated by the history, risk factors or other information
  8. perform other tests such as keratometry, as required to identify changes from baseline
  9. determine the best spectacle visual acuities following lens removal, if appropriate
  10. assess the patient’s compliance with the care system and general contact lens related hygiene, irrespective of lens type
  11. remind the patient of the importance of avoiding contact with water, and
  12. discuss clinical findings and advise the patient of the need for:
    • regular follow-up care, which may have become less obvious over time to existing wearers, and
    • a contact lens assessment before the contact lens specification expires. This is essential to the further supply of contact lenses.
A349
If a patient is considering a new type of lens, you may perform the tests and assessments which are relevant to new wearers. See section on Fitting contact lenses
A350
You should schedule contact lens check-ups according to the patient’s clinical needs. This will be more or less frequent depending on your analysis of the risks of contact lens wear. This will depend upon the patient’s clinical circumstances, the type of lens and modality of wear. 

Re-issuing the contact lens specification

A351
A patient might ask you to re-issue or revalidate their specification. In this case, you should tell the patient that you cannot do this unless you know what lenses the patient is wearing. This is because you are responsible for the content of the specification and, therefore, for ensuring that all details on it are correct. Where you have doubts about the specification of the current lenses the patient is wearing, you may need to re-fit the patient. 

See also paras A306-A318.

Routine eye examination

A352
There is an ongoing responsibility for the total optometric care of the patient and this would include periodic eye examinations. Where the eye examination is not combined with the contact lens check-up you should explain this to the patient and tell them when a full examination is required see para A346.  

Aftercare

A353
For information on aftercare, please refer to the section on Contact lens supply.
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