Patient Education - Lecture 6

What are the type of visits that occur for CL

• initial consult → first visit to get CL or update CL prescription

• Follow up visit → check the fit for trials ordered /check a tolerance trial

• Teach → px taught how to insert and remove their CL

• Aftercare → ongoing health check up, usually every 6 months

What does the dispensing visit seek to do?

• teach the correct methods of lens Insertion and removal

• explain methods that optimise lens comfort → understanding if lens inside out/has debris

• inform px about likely adaptation issues that may be encountered

• outline the correct use of the prescribed regimen

what should the teaching area be prepared with before the teach ?

• CL → cross checked with clinical record + spectacle prescription

• lens case & trial pack of solutions

• saline → for rinsing lens or rehydrating whilst in use

• comfort drops → to provide relief from mild agitation to ocullar tissue from learning I&R

• Tissues

• Hand washing facilities

• Mirror → ideally double sided → one side magnified

how to check lens is the correct way ?

• look at it from the side

• place cL on your fingertip → edge should be facing up (cup)

• edges curve upright , if lens inside out → shape of a rimmed bowl

Insertion of CL

• wash and dry hands

• open foil for disposables and scoop lens out with your index finger

• check lens is right way and for damage or debris

• place CL on tip of index finger and with free hand pull top eyelid

• pull bottom eyelid down and bring lens towards centre of your eye

• Oncel lens inside move eyes from side to side and then close them both

• repeat with other eye

Removing CL

• stand in front of well-lit mirror

• look upwards

• take non-dominant hand and use index finger to raise upper eyelid away from your eye

• with dominant hand use middle finger and pull down lower eyelid

• with pads of your index finger and thumb gently squeeze lens to pull it down and away from your eye

Cleaning CLs

• once lens in palm squeeze fresh cleaner into into surface

• rub lens with pads of your fingers for 30 seconds

• repeat for other side of the lens

• put lens into your case

• cover it with fresh solution and then cap

Do’s of CL

• regular check ups as advised by your practitioner

• always wash and dry hands prior to handling lens

• always rub, rinse and store lenses in recommended solution before and after each use

• always clean lens case with solution, wipe with clean tissue then air-dry after each use by placing case and lids face down on a tissue

• always apply same lens first to avoid mixing them up

• check lens not inside out or damaged before applying

• handle carefully to avoid damaging lens

• apply before make-up , remove lenses first then remove make-up

• replace lens case at least monthly

DONT’S of CL

• dont use tap water on your lenses or lens case

• place lens on eye if it falls on the floor without cleaning and storing again

• apply lens if its dirty, dusty or damaged

• sleep in your lenses

• use lenses for swimming , hot tubs or water sports

wearing schedules for CL

• First time CL wearers advised to initially wear lenses for 4 hours on first day and increase next consecutive wearing days by no more than 2 hours each day up to max wearing time

• Day 1 → 4 hours

• Day 2 → 6 hours

• Day 3 → 8 hours

px should be encouraged to have a days break if they wish to wear full time

What are the 2 types of non-compliance

• Intentional non-compliance & unintentional non-compliance

Intentional non-compliance

• could be improved acting on modifiable perceptions and influential factors of each px

Unintentional non-compliance

• could be improved enhancing education process about hygiene , care and maintenance of CLs

recognising emergency what 3 questions to ask yourself

• Do my eyes feel good with my lenses ? → no discomfort

• Do my eyes look good? no redness

• Do I see well → no unusual blurring with either eye

informed consent of wearing CLs

• px should be made aware of both risks and benefits of CL wear as well as having opportunity to ask questions

• information provided verbally should be reinforced with written material

• standard form can be used which px signs to acknowledge they’ve been given necessary advice + instructions

• in the case of elf under 16s → form should be signed by parent and child