CONCEPT

CRTs (also known as Ortho-K) are a specialty hard contact lens (RGP) that is worn while sleeping. At night, the contact lens temporarily alters the shape of your cornea, correcting your refractive error. When you wake up, the lens is removed and you should be able to see clearly at distance without corrective glasses or lenses. Again, the change is temporary, and to achieve clear vision during the day the CRTs must be worn every night. The change also takes time, so if a patient is unable to get a full-night sleep most nights, their vision may not be corrected as well as they would like. A CRT fit involves the doctor taking a series of measurements to assess whether or not the patient is a good CRT candidate and, if so, what parameters are needed in the CRTs to correct the patient’s refractive error.

Please watch the following video on CRTs

WORKUP ORDER

Complete Topography (must have a topographer, not just keratometry readings, for a CRT fit), visual acuity, expedited medical history.

CHARTING CHECKLIST

  • Layout: CRT Fit

  • Hx/Meds: Forward and update as needed.

  • Workup: Enter CRT fit as the chief complaint. Fill in VAs, pupils, and EOMs. The doctor may also recheck the patient’s prescription, if so, 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.

  • CL/Ref: Create a cl entry titled CRT Fit. Double check with the doctor which CRT sku they want entered. Record fit findings as well as the over refraction.

  • Routing: Check to see if the CRT fit was billed at a prior visit on the ledger, use the 1st-time fit dropdown box to select CRT. Indicate in the contacts notes box that the patient was fit into CRTs today. CRT checks should already be scheduled, if not, indicate when the next visit needs to be. In additional notes, indicate if/when the patient needs their I&R scheduled (often the doctor will complete I&R with the patient during the fit).