We had over 330 successful respondents to this exercise which was aimed at encouraging the discussion of the legal considerations relating to contact lens fitting and prescribing. The answers to the multiple-choice questions were as follows:
1 What is the recommended maximum time limit between a contact lens fitting and the issuing of the specifications to a patient?
Answer: Three months.
2 Which of the following statements regarding a patient obtaining contact lenses from an internet supplier is true?
Answer: The internet seller has responsibility for the aftercare arrangements for the patient.
3 A patient happy with the comfort and vision of their contact lenses and has missed their last aftercare appointment (which had been recommended to take place three months ago) wants replacement lenses of the same specification without any clinical assessment. Which of the following statements relating to this is true?
Answer: You should not supply the lenses outside the recommended time frame for clinical assessment.
4 Which of the following statements regarding supply of contact lenses to a 15-year-old is true?
Answer: It is possible if the practitioner has made and recorded an assessment of the patient’s maturity and reasons for obtaining lenses.
5 Who may legally alter the prescription of a contact lens at an aftercare visit?
Answer: An optometrist.
6 Which of the following statements is true?
Contact lenses of an approximate corrective power to the one required may be offered in an emergency.
Interactive exercise
Legal issues surrounding the fitting and supply of contact lenses
Most responses we received covered the subject area reasonably well. The topic for discussion was as follows: Having issued a new contact lens specification to a patient, what advice might you offer to them after they reveal they are going to obtain their new lenses from an internet supplier? Is there any evidence linking internet supply and increased risk of adverse response? Why might there be an association?
The questions posed surrounding the fitting and supply of contact lenses were based on scenarios that may occur in your practice. It is important to realise that while these may not be everyday occurrences, when something does happen it is important to know how to deal with the issue. This will ensure you are doing the right things for your patients, but also protecting yourself in the event of anything going wrong and your actions being called into question.
To summarise, there are a few basic facts that you should follow to keep yourself safe. Only a registered optometrist, medical practitioner or dispensing optician may fit a contact lens and to do so you must have a prescription from a sight test that is less than two years old or the fitting begins before a specified re-exam date on the prescription.
Following completion of a contact lens fitting the patient must be given a copy of their specification sufficient to enable the lens to be replicated. The patient must also be given instruction on the care, wearing, treatment, cleaning and maintenance of the contact lens. You will also need to give the copy of the specification following an aftercare as this will enable the patient to maintain supply of lenses.
Patients are able to purchase legally from the internet and while this may be annoying you still have to follow our professional and legal obligations to provide care. Use the conversation to better understand their motives for purchasing elsewhere and to make sure they are aware of the benefits of purchasing from the practice. This may also inform your future fee structure for the practice.
To supply lenses you need to have a signed written specification, or a copy that is verified with the person who provided it, that is in date and you should not supply lenses significantly beyond the expiry date.
To fulfil your professional obligations you should advise patients of options that are available to them and allow them to make an informed choice.