Week 10 - I&R and Legal Flashcards
How does setting for I&R need to be done with the Px?
• Set up in quite room
• Make sure Px relaxed
• Magnifying mirror, tissues, spare lenses etc
• Reassure px that not everyone manages first appointment
What advice should be given during I&R?
• Do a demo
• Offer px a break
• Once handling is mastered, go over care regime
• Discuss signs/symptoms they should look out for that might indicate a problem
What should a px do before I&R?
• Wash hands
• Look at fingernails - specifically length and hygine
• Debate around acrylics/long nails - should find solution or say no?
What should be done for soft lenses?
• Practice lid control
• Px happy touching conj
• Look for lid damage/check if inside out
What should be done for RGP lenses?
• Practice lid control
• Have px being happy touching conj
• Before insertion, check damage or debris on lenses
How is Paediatric I&R done?
• Teach child but have the parent aware of how they are doing it
• Needs LOTS of patience
• No minimum age for success
How can compliance be in-forced?
• Do’s and Donts forms
• BCLA leaflets
• GCU consent forms
What equipment is legally required?
• Essential:
- slit lamp (at least 25x mag)
- Keratometer
- Infection control procedures
• Recommended:
- Diagnostic lenses
- Lens care systems
- Appropriate topic drugs/diagnostic agents
Who can legally fit contact lenses?
• Registered optometrists
• Doctors
• Contact lens opticians
• Trainees under appropriate supervision (supervisor must be on the premises)
What 3 points must be legally told to the px?
• 1: apply and remove their contact lenses
• 2: care for (store, treat, disinfect and clean) their contact lenses,
•3: schedule the wearing and replacement intervals of their contact lenses
What 3 points must be told to px on seeking professional advice?
• a: if they experience discomfort, redness, watering, visual disturbance or other
problems
• b: before changing to a solution which has not been recommended by you
• c: before accepting a supply of substitute contact lenses.
What is a contact lens specification?
• Just like with a spectacle prescription, you must issue a CL specification on completion of the fitting (when the trial has concluded)
• This is a must for powered lenses and advised for zero powered lenses
- Sufficient details of contact lens fitted to enable lens replication
- date the specification expires
Why is expiry date important?
• Expiry date down to clinical judgement
• If clinical review earlier than expiration date of specification - then should include both dates (eg dry eye review)
• Advise px they need their next aftercare before expiry date, if want supply of lenses
What needs to be done for a contact lens supply?
• Lenses must match the specification
• Specification must be valid
• Anything else would be considered a re-fit and the fitting principles apply
• If you supply lenses you must make arrangements for an aftercare
• Supply an amount of lenses appropriate to the expiry date of the specification
What 9 points must be covered during contact lens check-ups?
• Record care system
• VA and over-refraction
• Assess lens fit and condition
• Assess condition of the eye on lens removal with a slit lamp and appropriate diagnostic agents
• Additional tests such as keratometry.
• Spec VA if appropriate
• Compliance with care system and hygiene
• Tap water reminder
• Discuss findings and date of next visit
