- When you examine a contact lens wearer you should carry out all the required key assessments, record your findings and communicate them to the patient.
- You should give the same level of care to patients wearing powered or zero powered contact lenses.
- You should schedule contact lens check-ups according to the patient’s clinical needs. This will depend upon your analysis of the risks of contact lens wear.
- If you are asked to re-issue or revalidate a patient’s contact lens specification you are responsible for the specification and should check the lenses they are wearing.
A432
This Guidance does not change what you must do under the law.
A433
You must regularly assess the general ocular status of a patient who wears contact lenses, or seek assurances that another practitioner is doing so.
A434
If you carry out a contact lens check-up and re-issue the patient’s specification for the same or different contact lenses, you are considered to be fitting the patient with contact lenses.157 You must not fit a patient with contact lenses unless they have an up-to-date spectacle prescription158.
A435
You should give patients wearing powered or zero powered contact lenses the same degree of care.
References
157 Opticians Act 1989 s25(9)(a) [Accessed 1 Nov 2023]158 Opticians Act 1989 s25(1A) [Accessed 1 Nov 2023]
A436
When you examine a contact lens wearer, you must conduct an adequate assessment.159 You should:
- assess the patient’s wearing patterns and wearing times and how the contact lens performs against their expectations, for example in comfort and handling
- identify any symptoms they experience while wearing contact lenses or any signs noted during wear or after contact lens removal
- record the patient’s current care system
- measure the refractive status and acuities with the contact lens on the patient’s eye, including astigmatic elements as appropriate
- assess the contact lens fit and the condition of the contact lenses themselves
- on removal of the contact lenses, examine the eye and adnexa using a slit lamp to detect any contact lens related adverse effects. This will include the use of appropriate topical drugs and diagnostic agents
- include additional tests which are indicated by the patient's history, risk factors or other information
- perform other tests such as keratometry, as required to identify changes from baseline
- determine the best spectacle visual acuities following contact lens removal, if appropriate
- assess the patient’s compliance with the care system and general contact lens related hygiene, irrespective of contact lens type
- remind the patient of the importance of avoiding contact with water
- discuss clinical findings and advise the patient of the need for:
- regular follow-up care, which may have become less obvious over time to existing wearers
- a contact lens assessment before the contact lens specification expires. This is essential to the further supply of contact lenses.
A437
If a patient is considering a new type of contact lens, you may perform the tests and assessments that are relevant to new wearers. See section on Fitting contact lenses.
A438
You should schedule contact lens check-ups according to the patient’s clinical needs. This will be more or less frequent depending on your analysis of the risks of contact lens wear. This will depend upon the patient’s clinical circumstances, the type of lens and modality of wear.
References
159 General Optical Council (2016) Standards of Practice for Optometrists and Dispensing Opticians para 7.1 [Accessed 1 Nov 2023]A439
A patient might ask you to re-issue or revalidate their specification. In this case, you should tell the patient that you cannot do this unless you know which contact lenses the patient is wearing. This is because you are responsible for the content of the specification and, therefore, for ensuring that all details on it are correct. If you have doubts about the specification of the current lenses the patient is wearing, you may need to re-fit the patient.
See also section on Contact lens specification.
A440
There is an ongoing responsibility for the total optometric care of the patient, including periodic eye examinations. If the eye examination is not combined with the contact lens check-up, you should explain this to the patient and tell them when a full examination is required. See section on Contact lens check-ups.
A441
For information on aftercare, please refer to the section on Contact lens supply.
The College of Optometrists. Higher qualifications in contact lens practice [Accessed 1 Nov 2023]
The College of Optometrists and The Royal College of Ophthalmologists (2015) Rules and regulations on sight testing and contact lens fitting and supply [Accessed 1 Nov 2023]
Efron N and Morgan PB (2017). Rethinking Contact Lens Aftercare. Clin Exp Optom;100:411-431 [Accessed 1 Nov 2023]
