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    Tips to become a better contact lens technician

     

    Visual acuity/corneal curvature

    When testing visual acuity, it is important not only to record the near and distance acuity but to record how the patient reads the letters (20/20 easily vs. 20/20 with effort) or at near (J1 easily vs. J1 with effort).

    Many practices use automated refractor/keratometers, making it impossible to evaluate the quality of the mires. For practices performing manual keratometry, any mire distortion or doubling should be recorded.

    The gold standard for corneal curvature is topography, which will show the contour of the cornea over a much wider area and indicate irregularities. Contact lens technicians who master the techniques of keratometry and topography will increase their skills and save time for the doctor, thus increasing their value to the practice.

    Related: The proper procedure for testing pupils

    Contact lens emergencies

    A good history of how the “emergency” occurred, followed by a check of visual acuity and inspection of the lenses for buildup, damage, or warpage is essential. Questions to ask the patient include:

    • Tell me how your eye feels?

    • Is there pain, redness, discharge, or swelling?

    • When did the symptoms start?

    • Was the onset gradual or sudden?

    • Did you try to treat them in any way?

    • Did you go to your primary-care physician or the emergency room first?

    • Did you sleep with your contact lenses last night, wear them in a smoky environment, or wear them longer than usual yesterday?

    • Are your eyes unusually sensitive to light?

    Related: How staff can prepare for ICD-10

    Routine follow-up

    Routine follow-up visits should be scheduled late in the day (except for patients wearing extended wear lenses) because redness, dryness, and other problems tend to show up after lenses have been worn for several hours. Visual acuity should be checked, and keratometry or topography repeated if indicated.

    Questions to ask include:

    • How many hours have you worn your contact lenses today?

    • How many hours do you wear your contact lenses on a typical day?

    • What lens care solutions are you using? Patients may have switched from the recommended care solution to a solution that is incompatible with their contact lenses or to which they are sensitive.

    • Tell me what you do when you remove your contact lenses at the end of the day? Patients may have switched solutions, may not be rubbing their lenses prior to disinfection, or may be “topping off” the lens case without rinsing their cases and refilling them with fresh solution each day.

    • Let me see your contact lens case. Cases harbor harmful micro-organisms. Besides nightly rinses, it is good practice to wipe the case with a cotton ball dipped in alcohol weekly and replace it every time a new bottle of disinfecting solution is started.

    Phyllis L. Rakow, COMT, NCLM, FCLSA(H)
    Phyllis Rakow, COMT, NCLM, FCLSA(H) is a JCAHPO-certified ophthalmic medical technologist, at a large three-location group practice in ...

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