Week 3 - CL Compliance Flashcards
What is compliance?
• Cooperation or obedience (definition)
• Applies throughout healthcare
• Simply the act of a Px following the instructions from their health care professional
What is the definition of contact lens compliance?
“In the contact lens field, compliance may be interpreted as a wearer who correctly adheres to the guidelines provided by the eye care professional in order to achieve optimum lens wear and care”
- Bausch and Lomb
What are the hygiene compliance rules?
• Hand washing
- With soap and air drying is best
- Avoid moisturising soaps; deposits
- Alcohol gel is not a replacement
• Fingernails
- Palm of your hand towards you. Shot finger nails preferred.
What are the Schedule/Wear time compliance rules?
• Can be done with all lens types
• Can be an extra hour during the day
• Or napping/sleeping in lenses that are not for extended wear
• Maximum wearing time exceeded (Sporadically = Accidentally.
Regularly = Deliberately)
What are the Lens Disposal/replacement compliance rules?
• Sleeping in lenses only designed for daily wear
• Over-wear (Non-Disposal): Saves money i.e. dailies for 2 days, monthlies for 30 uses not 30 days.
• Use-By dates ignored
What are the Care System compliance rules?
• Case cleaning and replacement
• Will be covered in more detail in care system lectures for both soft and rigid lenses.
What stages of the care system are important?
• Cleaning (rub and rinse)
• Pre-insertion rinse
• Fresh solution each time
• Tap water should NOT be involved in the care system
• In the test room the patient should demonstrate
What stages of the handling the lenses are important?
• No dispense until compliant with good practice
• Demonstration at each after care visit
- to check bad habbits
- to check understanding of instructions
• Bad practice gradually creeps in with most patients
• Check hygine
Why is aftercare an important stage for compliance?
• Failing to attend regular check-ups but still wearing lenses, this is non-compliance
• Therefore extending the life of the lens
• Buying online without checkups
• How often should a CL patient be seen?
• As often as you determine is necessary! Depends on modality of wear, ocular health etc. Covered in Aftercare lecture.
What are the general do’s of contact lens wear?
• Always wash hands
• Check lens before insertion
• Follow care regime
• Insert lens before applying make up (and remove lens before removing makeup)
• Eyes closed when applying hairspray
• Always have up to date glasses
• Follow wearing schedule and replacement schedule
What are the general dont’s of contact lens wear?
• Tap water
• Wearing lenses if ill
• Wearing lenses if eye red or uncomfortable or blurred vision
• Swimming
• Showering
• Hot tubs/saunas
• Make up on lid margin
• Share lenses
• Sleep in lenses (unless EW)
• Saliva to wet lenses (yes people do this)
• Switch solution
• Topping up/reusing solution
What are the consequences of non-compliance?
• Contact lens discomfort
• Reduced wear time
• CL drop out
• Practitioner not issuing CL Rx
• Keratitis (mild to sight threatening)
What are the 2 reasons why patients dont comply?
- Intentional non-compliance - patient is making the choice not to follow the instructions given by their practitioner
- Accidental non-compliance - patient either doesn’t realise ey are non-compliant or occasionally makes a mistake by ccident
What are the reasons for intentional Non-Compliance?
• Time constraints
• Cost reduction
• Effects of alcohol or drugs
• Failure to comply with instructions (simply do not do what they are told)
• Retaining favourite cases or multiple cases
• Lens pick-up delayed
What are the reasons for Accidental Non-Compliance?
• Accidental (overwear, sleeping in D/W lenses)
• Lens pick-up forgotten
• Ordering forgotten
• Solution mix-up
• Care system too complicated - misunderstood
