CONCEPT

Whenever someone would like to try contact lens wear for the first time, they are usually scheduled back for a CL fit. This intermediate, unlike most, is scheduled in a 30 minute slot to allow the doctor time to determine which contacts would be most appropriate for the patient based on their ocular history and lifestyle and time to insert and remove the contacts, which could take longer for new contact lens wearers (especially younger ones). Another reason this fitting is not done at the exam is that the patient will also need to complete an I&R (insertion & removal) class where the patient demonstrates, in office, that they can insert and remove the contact lenses a minimum of three times on their own. If the patient does not pass the I&R, they will have to return for I&R before they are able to take the contacts home to trial. Every effort should be made to schedule the I&R the same day as the CL fit so that patients can take their new contacts home to trial as soon as possible.

Please watch the following video on contact lens insertion and removal.

WORKUP ORDER

Complete topography (or keratometry on the autorefractor if you are working in an office without a topographer) visual acuity, expedited medical history. Inquire if the patient has ever worn cls before and if they intend to wear the cls full-time or only for specific activities.

CHARTING CHECKLIST

  • Layout: CL Fit

  • Hx/Meds: Forward and update

  • Workup: Enter CL fit as the chief complaint. Fill in VAs, pupils, and EOMs.

  • Exam: Forward anterior and posterior findings (delete the posterior findings) and update based on the doctors findings. Forward the patient’s refractive error in the plan and make it the #1 diagnosis for the appointment. Update plan to reflect all recommendations from that appointment.

  • Testing: Create and entry for the topography (and import the image if able)

  • CL/Ref: Create an entry for the cls the doctor fits the patient into (may end up having multiple entries) titled CL fit. Record all the doctor’s findings and clearly indicate, if multiple cls were tried, which cls the patient is to trial at home.

  • Routing: Use the CL Fit dropdown box to enter the appropriate cl fit level (standard for all non-MF, non-specialty cls; advanced for all MF, non-specialty cls; specialty for all specialty cls). Indicate in the cl notes box what cls the patient was fit into, whether or not their I&R is scheduled that day and at what time, and when to schedule the patient’s cl check.