The College of Optometrists

Examining contact lens wearers

A406
When you examine a contact lens wearer, you must conduct an adequate assessment.146 You should (refer to COVID-19 guidance): 
  1. assess the patient’s wearing patterns and wearing times and how the contact lens performs against their expectations, for example in comfort and handling
  2. identify any symptoms they experience while wearing contact lenses or any signs noted during wear or after contact lens removal
  3. record the patient’s current care system
  4. measure the refractive status and acuities with the contact lens on the patient’s eye, including astigmatic elements as appropriate
  5. assess the contact lens fit and the condition of the contact lenses themselves
  6. on removal of the contact lenses, examine the eye and adnexa using a slit lamp 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 patient's 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 contact lens removal, if appropriate
  10. assess the patient’s compliance with the care system and general contact lens related hygiene, irrespective of contact lens type
  11. remind the patient of the importance of avoiding contact with water
  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
    • a contact lens assessment before the contact lens specification expires. This is essential to the further supply of contact lenses.
A407
If a patient is considering a new type of contact lens, you may perform the tests and assessments that are relevant to new wearers. See section on Fitting contact lenses
A408
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. 

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