Contact Lens Assessment

Initial assessment

During the initial contact lens assessment the optometrist will discuss in detail exactly what is required from a contact lens, when they will be worn, the intended duration of wear, previous experience with contact lenses, past and present general health, past and present ocular health etc. The eye will then be examined meticulously using the slit lamp microscope; anterior eye imaging may be utilized to document baseline eye appearance or abnormalities using photographs or videos before contact lens wear.

The optometrist will inspect, grade and record the health of the eyelids, eyelashes, conjunctiva, episclera, sclera and cornea etc. Various dyes may be instilled in the eye including fluorescein and lissamine green (this process is completely painless and does not affect vision, so driving afterwards is safe) allowing a better view of the front of the eye. The volume and quality of the tear film will be assessed and graded using a variety of techniques, to ensure dry eye will not cause discomfort whilst wearing contact lenses. The curvature of the cornea will be measured using automated keratometry; this will enable the correct size and shape of contact lens to be selected, which is particularly important in rigid gas permeable lens or complex soft lens fitting.

The optometrist will discuss the results from the aforementioned examinations and make a recommendation based on the clinical information gathered in conjunction with the individuals’ needs on which type of lens is most appropriate. Diagnostic lenses (trial lenses) will then be selected (such lenses may need to be ordered in complex cases) and placed on the eye by the optometrist. After a brief adaptation period (a few minutes) vision is checked wearing the lenses and adjustment made to the prescription if required. The fit of the contact lens is assessed using the slit lamp microscope.

Contact Lens Handling Session

If the lenses are deemed successful a contact lens handling lesson will be arranged (this is usually conducted on the same day or occasionally this may need to be re-booked as a separate appointment), where an experienced member of the clinical staff will offer a detailed guide through the following

  • Lens application and removal technique
  • Wearing instructions suitable for the lens selected
  • Contact lens care and cleaning regime
  • Use of contact lens solutions and hygiene advice
  • Contact lens 'do's and don'ts'

Once the contact lens handling session has been completed trial lenses and any required cleaningstoringrinsing solutions will be issued to the patient, allowing them to try contact lenses within their own environment e.g. at home, in work etc.

Follow-up appointment

After a trial period (which may vary from a few days to a few weeks depending on the type of contact lens prescribed) a follow-up appointment (contact lens check-up) will be arranged. Contact lenses should be worn to this appointment, having ideally been in the eye for a few hours before the appointment. The optometrist will review how successful the lenses have been in terms of ease of use, clarity of vision and comfort. Vision will be checked and any necessary adjustments to the prescription made. The fit of the contact lenses will be checked using the slit lamp microscope and adjustments may be made to the shape, size and overall fit of the contact lens if required. The lenses will then be made and a meticulous inspection of the health of the front of the eye will be conducted to look for any changes caused by use of contact lenses.

At the end of this consultation the optometrist will discuss and make a recommendation based on the clinical results from the various consultations and feedback from the patient on how best to continue with contact lenses, e.g. part-time wear, full-time wear, extended wear etc.

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