The lifestyle conversation 101

Over time, I’ve learned that even brief comments such as asking about hobbies, work patterns and screen time can reveal valuable information that will help you tailor your clinical recommendations to each patient.

Starting with these small, open prompts makes history taking feel more like a conversation rather than a tick box exercise, and it helps me tailor advice in a way that feels more personal and meaningful to the patient.

I remember trying to strike a balance between taking a thorough history without making it seem as if I was prying, especially when asking questions relating to work routines or daily habits

The when and how

Looking back on myself to when I was newly-qualified, asking lifestyle questions during history taking was something I was conscious about. I remember trying to strike a balance between taking a thorough history without making it seem as if I was prying, especially when asking questions relating to work routines or daily habits. Over time though, I’ve learned that it’s all about how you ask these questions, and I find that weaving them into the history taking, listening out for cues and exploring them with curiosity, rather than seeing it as a separate section of the history, makes the conversation feel more natural and purposeful.

I’ve also found that posing open ended questions at the start of the appointment gives patients the space to describe their daily visual experience in their own words, as well as the opportunity to reveal more information without feeling as if they are being tested.

Once I have a general picture, I’ll follow up with more focused, closed questions to clarify details. This layered approach helps ensure I gather the relevant clinical information whilst keeping the conversation patient-led. In addition to this, using a warm, friendly tone reassures patients and helps them feel more relaxed during these initial conversations.

The lifestyle questions that are asked don’t just guide management; they help build rapport too. Patients often appreciate being asked about their routines, as it reinforces the concept of a personalised approach

The what

During history taking, I always ask about occupation, screen time, and working distance for digital devices. These questions give me a clearer picture of how patients use their eyes day-to-day, which in turn helps guide clinical recommendations. For example, knowing whether someone works from home on dual screens versus being out on the road all day influences what I recommend, from lens design to dry eye advice.

I also ask about any regular sports or hobbies, especially those that rely on good visual clarity and comfort. Something as simple as a patient mentioning hours spent gaming or sewing can reveal factors to consider such as lighting, which may impact the symptoms they have presented with.

The lifestyle questions that are asked don’t just guide management; they help build rapport too. Patients often appreciate being asked about their routines, as it reinforces the concept of a personalised approach.

For a lifestyle conversation to be effective, it is not just about what you ask and how you ask it, but your body language too. I always avoid facing my computer screen when asking questions. Instead, I face the patient and listen attentively, making sure not to cut them off mid-sentence.

In those early moments of history taking, I believe it’s imperative to build trust and display full engagement in what the patient is saying. Interrupting them, even with good intentions, can break that flow and discourage them from sharing useful insights about their lifestyle and visual needs.

Similarly, if your attention is fixed on the computer screen, it can unintentionally signal that the computer is more important than what the patient is saying. Instead, I prioritise eye contact, active listening, and pausing between their responses to make brief notes. I find this approach helps patients feel heard and encourages a more open conversation which ultimately sets the tone for a patient-centred approach.

Even if a patient hasn’t previously considered contact lenses, lifestyle details can prompt offering contact lenses as an option framed around their own visual goals

Contact lenses in conversation

During the lifestyle conversation, I’m always listening out for clues that might suggest contact lenses could enhance the patient’s day-to-day life. For example, if a patient mentions that they’re looking to purchase a new pair of glasses to give them a different look, or if they’re struggling with glasses for a certain sport, then this opens the door to discussing contact lenses as a practical alternative.

Even if a patient hasn’t previously considered contact lenses, lifestyle details can prompt offering contact lenses as an option framed around their own visual goals.

I always try to link the idea of contact lenses to something the patient has shared about their lifestyle. For example, if a patient mentions playing golf, I will ask, “In an ideal world, when you’re out playing, would you prefer to be able to see without your glasses on?” If the answer is yes, then this naturally opens the door to suggesting contact lenses as an option. I’ve found that phrasing questions this way helps patients visualise how lenses could benefit them, especially if they haven’t considered them before and that this is better responded to instead of suggesting contact lenses as an option out of the blue.

I’ve found that when I link contact lenses as a suggestion to something they’ve mentioned during history taking, patients are far more open to exploring it as a visual correction solution.