A team approach to delivering contact lens care

1. Preparation is key

Prepare the space

• Ideally a well-lit, calm, clean space, away from interruption
• Arrange the contact lenses, cleaning solutions, and any patient instruction or information leaflets you will need in advance of the session.

Prepare yourself

• Get recommendations from the eye care practitioner (ECP) as to when to review the patient, the lens wearing times, suggested cleaning solutions and any other relevant information such as whether the patient is anxious or has any previous experience of using lenses
• Have a checklist of topics to cover during the teaching session.

Prepare the patient

• Explain that it can take a number of visits before someone feels ready to take lenses home and that you should both be confident in their ability before they can do so.

2. Instruction

Repetition of instructions is helpful so consider doing this in a variety of ways such as verbally, through physical demonstrations and with written or online information to access at home.

Hand washing

• Stress the importance of hand washing before touching lenses
• Demonstrate this to the patient and ask them to wash their hands too.
  

Lens inspection

• Demonstrate how to tell if the lens is inside out
• Encourage the patient to inspect the lens for any damage or deposits each time they handle the lenses, explaining that they should never insert a dirty/damaged lens.

Application and removal

There are many subtly different techniques for application and removal depending on the person and the type of lens. Be flexible with your approach, working with the patient to find the technique that suits them best. Regardless of the preferred technique, ensure a successful application or removal is not a fluke by asking the patient to repeat this without any instruction, as they won’t have this at home.

There are many subtly different techniques for application and removal depending on the person and the type of lens

3. Essential care

Cleaning

• Advise the patient to always gently rub the lenses clean after wear
• Demonstrate lens cleaning then ask the patient to clean a lens until they can do it without your instruction
• Stress the importance of avoiding tap water with lenses or cases
• Provide a starter pack of solutions for the trial period and ensure the patient knows what to look for if replacing the solutions themselves
• Direct the patient to the instruction/advice leaflet that comes in the box of lens cleaning solution.

Dos and don’ts

• Don’t swim, shower or use hot tubs while wearing contact lenses
• If a patient feels they have to swim in their lenses, then use well-fitting goggles and clean or replace the lenses immediately afterwards
• Don’t sleep in contact lenses, unless specifically instructed by the ECP
• Put makeup on after applying lenses and use it sparingly along the lash line.

Care of cases

• Explain that the case is the perfect place for germs to grow so keep it clean by rinsing it with solution
• Advise the patient to empty the case after each use, rinse with solution, and wipe with a tissue and allow it to air dry
• Advise refreshing the solution each time the lenses need to be stored
• Suggest replacing the lens case every few months.

Provide a starter pack of solutions for the trial period and ensure the patient knows what to look for if replacing the solutions themselves

4. Record keeping

• Record the wearing schedule, solution type, method of insertion and removal, and any problems that may need to be addressed in subsequent handling sessions
• Use a checklist, which the patient can sign to record that you have discussed all elements of the handling session with them. This can form the basis of a consent form.

5. Arranging aftercare

• Book a follow-up appointment before the patient leaves
• Ensure the patient has enough lenses and solutions for the trial period
• Encourage the patient to attend the aftercare appointment wearing their contact lenses.

6. Take home information

• Book a follow-up appointment before the patient leaves
• Ensure the patient has enough lenses and solutions for the trial period
• Encourage the patient to attend the aftercare appointment wearing their contact lenses.

Image credit: CooperVision