21. How to: Aftercare

Question 1

Biggest cause of contact lens drop out is?

Answer 1

Discomfort

Question 2

Causes of contact lens drop out?

Answer 2

1. Discomfort **
2. Dryness
3. Redness
4. Vision
5. Expense
6. Convince

Question 3

Why is it important to identify patients that are likely to drop out during aftercare assessment?

Answer 3

To identify px’s that are at high risk of drop out and reduce drop out and help patients navigate through the problems that they might face.

Question 4

Typical aftercare appointment duration is?

Answer 4

12 months

Question 5

What does aftercare mean?

Answer 5

Check-up of existing lens wearer this could be after completion of fit or routine after care. sometimes patients can come incase of problems.

Question 6

Why is aftercare needed?

Answer 6

1. CL wear can greatly affect the eye.
2. Opportunity to check px ocular status.
3. To ensure CL is still suitable.
4. To ensure px needs are meet.
5. To identify areas of non- compliance
6. Legal requirement for supply of CLs.

Question 7

When Px comes to aftercare, they are wearing the CL, why?

Answer 7

Opportunity to check VA and OR. Additionally, check lens fit and condition.

Question 8

When patient is removing lenses what is observed?

Answer 8

Watch patient technique, is patient washing hands?

Question 9

Keratometry is used sometimes, why is it used?

Answer 9

It is used to check the radius of curvature of the cornea. Also, monitor changes in corneal curvature.

Question 10

Once patient removes lenses what is the next step in an aftercare appointment?

Answer 10

Anterior eye exam– advice– recall

Question 11

History and symptoms role?

Answer 11

1. Find out about day to day wearing problems.
2. Make sure px is happy with their lenses, comfort and vision.
3. Find out if there is something different or better suited for your patient.
4. Identify patients at risk of drop out & offer solutions.
5. Identify non-compliance & offer advice to reduce the risk of complication.

Question 12

If non-compliance is identified, how do you address it to help the patient?

Answer 12

Advice patient while performing H&S and the end of the exam to help them understand better

Question 13

Instead of asking patients if they sleep in the lenses, what is another more open question related to the same case?

Answer 13

When was the last time you slept in your lenses?

Question 14

Tend in CL drop out?

Answer 14

As lenses get uncomfortable, px wears lenses for a shorter time and then less days. Eventually, they start wearing lenses only at irregular intervals then stop completely.

Question 15

Relation of up to date sight test to CL

Answer 15

Need to have an up to date sight test to be issued with prescription CL

Question 16

How to identify patient hygiene and compliance?

Answer 16

Ask patient to describe the routine that they follow.

Question 17

What are some possible identifiable risk factors with CL?

Answer 17

1.Water/ swimming/ showering.
2. Overnight wear (ON)/ napping.
3. Replacement/ re-wearing dailies?

Question 18

Biggest risk factor for acanthamoeba keratitis?

Answer 18

Water exposure

Question 19

Risk factors for MK (microbial keratitis)

Answer 19

1. Extended wear, overnight wear and occasional napping.— causes hypoxia.
2. Poor case hygiene & infrequent replacement.

Question 20

Why is there a lower level of severity of MK in daily lens wearers?

Answer 20

Due to lack of lens case

Question 21

Infrequent lens case replacement is associated with?

Answer 21

Moderate- severe MK

Question 22

Relation to compliance and aftercare intervals?

Answer 22

Compliance deteriorates with increasing aftercare intervals.

Question 23

Relationship with eye exam intervals and compliance?

Answer 23

Greater the interval between eye exams is associated with non compliant lens replacement frequency.

Question 24

How to help pxs that swim with CL?

Answer 24

Rx googles given, fitting them with dailies that are used just to swim then taken out once you are done with swimming.

Question 25

How to back up the advice you give?

Answer 25

Written material

Question 26

What is assessed with lens condition?

Answer 26

Deposits, drying, edge problems

Question 27

Keratometry is particularly important in what 2 categories?

Answer 27

1. RGP wearer- ensure no corneal molding by poor fitting lens.
2. Keratoconus patients- monitor progression

Question 28

2 uses of fluorescein in after care anterior eye exam?

Answer 28

1. Indicate chronic corneal changes
2. Indicate dryness secondary to CL wear

Question 29

Re-fitting booking appointment interval?

Answer 29

Next possible date

Question 30

Completing fit appointment interval?

Answer 30

3 months

Question 31

True or false, unless refitting needed it is a legal obligation to give px a copy of the rx

Answer 31

true

Question 32

New CL px seen regularly, why?

Answer 32

To prevent drop out