The College of Optometrists

Assessing patients

A347
When assessing a patient who wishes to wear zero powered contact lenses, you should conduct a sight test or ensure that the patient has had a sight test within the past two years (or within the timescale recommended at the patient’s last sight test). When assessing a patient who wishes to wear powered lenses, you must ensure that the patient has had a sight test within the past two years (or within the timescale recommended at the patient’s sight test), and you have the particulars of the prescription that was issued as a result124 (refer to COVID-19 guidance).
A348
You must conduct an adequate assessment.125 When assessing patients for contact lens wear you should (refer to COVID-19 guidance):
  1. include any additional tests indicated by:
    • symptoms
    • ocular and medical history
    • pre-disposing factors
  2. ask for, and consider, relevant information about:
    • history of allergies, including to components of contact lenses or their care products
    • history of systemic disease
    • previous contact lens wear
    • occupational and recreational needs
    • the environments in which contact lenses will be worn
  3. carry out a detailed assessment of the anterior eye which might be affected by wearing contact lenses. This should include:
    • a slit-lamp examination
    • keratometry or corneal topography
    • the use of diagnostic stains
    • the assessment of tear film quality and quantity
    • other factors, including the patient’s ability to handle and care for the contact lenses safely and hygienically
  4. discuss with the patient why you find them unsuitable for contact lens wear, if this is the case
  5. record all relevant information in the patient notes.
A349
You must not fit a patient with contact lenses if they are not able to use them safely.126

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