My name is Beth, I work as a locum contact lens optician for three independent companies. I have experience working with Boots, Specsavers, Vision Express and Asda along with several independents.
I have followed up patients seen by a wide range of practitioners from dispensing opticians with grandfather rights to newly qualified ECPs, optoms, ophthalmologists and contact lens practitioners.
It is true we all work differently and have different opinions on essential tests which should be done and recall dates. No two contact lens fits and aftercares are the same and no two patients are the same.
However, on my travels I have come across many practitioners who do not routinely use fluorescein and evert eyelids. I, however, believe these tests should be done on every contact lens wearer as routine not only to check eye health but to fine tune your own skills. It also desensitises the patient to their eyes being touched. Patients I see regularly know this is their routine and expect these tests to be performed.
It is common knowledge that some early silicone hydrogel lenses cause a lid reaction in some patients leading to GPC. Surely this can be prevented in the early stages if lids are everted routinely. I am spending much of my time refitting or treating patients who have had symptoms for several months but simply told by their previous ECP they have ‘dry eye’. However, the patient tells me they have never had their lids everted so was it ‘dry eye’?
There are patients who may resist these tests especially when they have never had it done before. I simply explain it is important to check their eye health to keep them successfully wearing their contact lenses for many years to come. Prevention is better than cure. If the routine is set from their first contact lens fitting then it is not a problem, it is expected.
However, it is frustrating trying to explain time after time why it is necessary when they have never had it done before yet worn contact lenses for many years and regularly attended their eye checks. So why did the previous ECP not feel it necessary?
I have decided to start a debate. I am interested in the opinion of other ECPs as to whether lids should be routinely everted or not on a contact lens fitting and aftercare? Am I being ‘over cautious’ (as I have been accused of in the past) or just doing my job?
I look forward to your responses.