CONCEPT

CRTs checks are used to check on how well the current CRTs are treating the patient’s refractive error. The 1st CRT check will be completed the morning after the patient’s first night of CRT wear; several other checks will follow at fixed intervals before the patient is given the ok to follow up at their next exam. A topography is completed at every CRT related visit (including exams) to make sure that the shape of the cornea is changing as intended (since this is what corrects the patient’s refractive error). If the doctor needs to make any adjustments to the parameters, new CRTs will be ordered.

During the fitting process, the doctor may change the CRT parameters several times. Each time the parameters change, the patient will exchange their previous lenses for the new ones. Once the fitting process has finished, the patient owns their CRTs (one per eye). If any alterations need to be made in the future, they would need to purchase an additional set. It is normal, since CRTs are often worn by children, whose eyes are still growing, that they may need to order new CRTs every year; however, they will not need to pay for the initial fitting process again, just the “CRT service” during their annual exam along with the actual lenses.

WORKUP ORDER

Complete Topography (must have a topographer, not just keratometry readings), visual acuity, expedited medical history. Inquire how comfort and vision have been with their current CRTs

CHARTING CHECKLIST

  • Layout: CRT Fit

  • Hx/Meds: Forward and update as needed.

  • Workup: Enter CRT check as the chief complaint. Fill in VAs, pupils, and EOMs. The doctor will recheck the patient’s prescription, record it in the appropriate table as a BVA.

  • 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 Topography entry and import image if possible.

  • CL/Ref: Forward the last CRT entry and title it CRT check. Record fit findings as well as the over refraction.

  • Routing: Click the clck - no charge box. Indicate in the Contact Lens box whether or not the doctor will be ordering new CRTs for the patient as well as any additional CRT checks that need scheduled.