Management Plans

Question 1

What should you discuss with px’s with regards to cl’s

Answer 1

• The risks and complications of wearing contact lenses, including the need to avoid exposure of contact lenses to water, including tap, shower, hot tub and swimming pool water
• The consequences of not complying with advice about how to wear contact lenses safely
• The advantages and disadvantages of available lens types, those that are most appropriate and the reasons for this
• Any contraindicated lens types and the reasons for this
• Care systems of different lens types and the risks of incorrect use of appropriate care systems for contact lenses and non-compliance with general contact lens related hygiene, and total estimated costs.

Question 2

Aspects to consider for a recommendation

Answer 2

• Do you have a particular budget in mind
• Frequency of wear?
• Duration of wear?
• Features of lenses available – wettability, UV, don’t dry out as easily
• Convenience vs hassle
• Health implications
• Eco minded patients – All contact lenses are plastic – recycling?

Question 3

What should lenses include if outside hobby

Answer 3

UV

Question 4

Short term management plans include

Answer 4

• Address the immediate issues – whatever is going on in that moment e.g hyperaemia or staining – whats the plan put in place to resolve what youre observing
• Detailed to resolve the current problem with the eye at that appointment
• May include a short review period
• Advice

Question 5

Long term management plans include

Answer 5

• What has to occur in the longer term for continued future contact lens wear
• May include change of lens type – material, compliance, wear time
• May include a change of wear time
• Review period
• Advice

Question 6

Example of short term management - corneal staining

Answer 6

• Deal with the staining
• Remove lenses
• Possibly discard depending on modality and material
• Allow to heal – How long?
• Consider Review
• Consider the reason for the foreign body?
• e.g. Suspect due to grit getting under an RCL lens and not being removed from cleaning (no rub)
• Remove lenses for 2 days, use of lubricating eye drops (preservative free) 3 x a day. Review in 2 days to resume lens wear.

Question 7

Example of long term management - corneal staining

Answer 7

• Address aspects for longer term, could be;
• Advice only?
• Replace lens? – if old
• Address a compliance issue? – removing wrong?
• Change of lens option?
• Re-educate on rubbing lenses during cleaning to prevent this issue in the future.
• If staining resolved at the review then stop use of drops and review in 12 months