CL Compliance Flashcards
1
Q
Describe hygiene in CL compliance?
A
- Hand washing:
o With soap & air drying is best – so not getting any bugs from towels etc
o Avoid moisturising soaps – leads to deposits on the lens
o Alcohol gel is NOT a replacement - Fingernails:
o Palm of your hand towards you – you should not be able to see end of your nails
Can lead to ripping lenses or scratches on cornea
2
Q
Describe schedule/wear time in CL compliance?
A
- Pxs will often not tell you that they are sleeping in them
- Can be done with all lens types
- Can be extra hour during day
- Or napping/sleeping in lenses that are not for extended wear
- Maximum wearing time exceeded (sporadically = accidentally, regularly = deliberately)
o Find out if it just happened once or it has happened more than once
3
Q
Describe lens disposal/replacement in CL compliance?
A
- Sleeping in lenses only designed for daily wear
o Should be binning daily wear lenses - Over-wear (Non-Disposal): save money i.e. dailies for 2 days, monthlies for 30 uses not 30 days (this is often due to communication)
- Use-by dates ignored – always check before opening them
4
Q
Describe lens disposal/replacement in CL compliance?
A
- Sleeping in lenses only designed for daily wear
o Should be binning daily wear lenses - Over-wear (Non-Disposal): save money i.e. dailies for 2 days, monthlies for 30 uses not 30 days (this is often due to communication)
- Use-by dates ignored – always check before opening them
5
Q
Describe care system in CL compliance?
A
- No case cleaning or replacing case
- Cleaning (Rub & rinse)
- Pre-insertion rinse
- Fresh solution each time
- Tap water SHOULD NOT be involved in care system
- In test room have the px demonstrate
We should prompt the px not sternly tell them off
6
Q
Describe handling in CL compliance?
A
- No dispense until compliant w/ good practice – must have I&R
o Px must not have long acrylic fingernails - Demonstration at each after-care visit:
o To check understanding of instructions – CLEAR COMMUNICATION
o To look for bad habits – look at nail length, have they washed hands, are they sliding the lens off eye? - Bad practice gradually creeps in with most patients
- Check hygiene
7
Q
Describe aftercare in CL compliance?
A
- Failing to attend regular check-ups but still wearing lenses – this is non-compliance
o Therefore extending life of lens
o They may not realise they are due – should flag up on your system - Buying online w/o checkups
- How often should a CL px be seen?
o As often as you determine is necessary!
Depends on modality of wear, ocular health etc
See EW pxs more often
8
Q
What are the general DO’s of CL wear?
A
- Always wash hands
- Check lens before insertion
- Follow care regime
- Insert lens before applying make up (& remove lens before removing makeup)
o Won’t get it covered in mascara if put in before makeup & won’t get it covered with the cleaning product if remove before taking makeup off - Eyes closed when applying hairspray
- Always have up to date glasses – in case of issues
- Follow wearing schedule & replacement schedule
9
Q
What are the general DO NOT’s of CL wear?
A
- Tap water - NEVER
- Wearing lenses if ill
- Wearing lenses if eye red or uncomfortable or blurred vision
o Do my eyes look good?
o Do my eyes feel good?
o Do I see well?
If no to any of these then do not wear – “if in doubt, take them out” - Swimming – lots of bacteria
o Rx goggles is best - Showering – equivalent of tap water – easy to get microbe on them
- Hot tubs/saunas
- Make up on lid margin – behind the lash line - could attach to lens but can also lead to MGD
- Share lenses
- Sleep in lenses (unless EW)
- Saliva to wet the lenses – often with RGP – rewetting drop is a better solution
- Switch solution – check it is appropriate for their lenses
- Topping up/reusing solution
10
Q
What are the consequences of non-compliance?
A
- CL discomfort – general umbrella term
- Reduced WT
- CL drop out
- Practitioner not issuing CL Rx – not safe due to such poor compliance
- Keratitis (mild to moderate to sight threatening)
11
Q
Why do pxs not comply?
A
- Intentional non-compliance – px is making choice not to follow instructions given by practitioner
- Accidental non-compliance – px either doesn’t realise they are non-compliant or occasionally makes a mistake by accident
12
Q
Describe intentional non-compliance?
A
- Time constraints
- Cost reduction – by over-wearing lenses
- Effects of alcohol or drugs – may fall asleep in them due to this
- Failure to comply with instructions – simply do not do what they are told
- Retaining favourite cases or multiple cases
- Lens pick-up delayed
13
Q
Describe accidental non-compliance?
A
- Accidental (overwear, sleeping in DW lenses)
- Lens pick-up forgotten
- Ordering forgotten
- Solution mix-up
- Care system too complicated – misunderstood
o These pxs are often happy to move to daily wear
14
Q
What are the clues of non-compliance (outside and in the test room)?
A
- Outside test room:
o Always late to collect lenses
o 3 month supply lasts 5 months
o Frequently claims to have a back log of solution
The bottles & cases are designed so they only last a month
o Crucial that practice team looks out for these things – check their record card for the dates - In test room:
o “Which date did you open these lenses?” – keeps question open
If they have no clue how old they are then this is a bad sign
o Always present wearing a new pair of lenses
We are looking to see them at the end of their wear
o Questioning on hygiene/care regime during or after SL
Px will know you can see the non-compliance on SL
o Px’s occupation/hobbies may have changed – may need different lens for this
o Examine px’s lens case
Bad sign if they never bring this
o Debris on lenses/in tear film
o Damage to lens on SL
Looking for scratches too
o Signs of hypoxia on SL
Cornea not getting enough oxygen
15
Q
How do you improve compliance?
A
- Verbal instructions – importance of non-verbal communication (don’t do it in a preachy way – work w/ px)
- Written instructions
- Picture instructions
- Demo in person – show cleaning, show good hygiene
- Video
- Practice – go over and over it again
- Updates (newsletter)
- Quiz (for young pxs)
- CL hygienist appt – someone in your practice trained up on this & go over it with the px
- Text/email reminders – monthly text to say “change your lenses” or “you’re due an aftercare”
- Staff training
- Price package that includes aftercare
