pediatric and teen cl care

Responsibility for Contact Lens Wear is a Team Effort

BY MARJORIE J. RAH, OD, PHD, & JEFFREY J. WALLINE, OD, PHD

A 13-year-old female contact lens patient had been wearing daily disposable lenses successfully for one year. She had received a six-month supply of lenses at her most recent appointment. She waited until she had used her last pair of lenses before calling to schedule her annual eye examination.

Her mother wanted contact lenses for her immediately, but her prescription had expired and a complete examination was necessary. The mother became angry that she needed to schedule an appointment and stated that her daughter had been wearing the same pair of daily disposable lenses for four days and refused to wear her glasses. She wanted to know who was responsible if something happened to her daughter's eyes.

Your Responsibility

When a patient of any age reports for a contact lens fitting, there are certain responsibilities that we as contact lens practitioners need to fulfill. First, we need to determine whether the patient is a good candidate for contact lenses. Be certain that the patient has no pre-existing medical conditions such as blepharitis, severe ocular allergies or ocular infection that would contraindicate contact lens wear.

Once you establish that a patient is a good candidate, it's your responsibility to find a contact lens that shows a proper physiologic response to the patient's eye. Instruct the patient on proper handling, wearing schedule, hygiene and care of the contact lenses, and inform him of the required follow-up appointments. The patient also needs to know what to do should an adverse event with contact lenses occur.

The Patient's Responsibility

Patients are responsible for providing accurate information regarding medical history and contact lens wear. They are also responsible for following the recommendations provided by their practitioner with regard to handling, hygiene, wearing schedule and lens care.

Scheduling timely follow-up appointments is also the patients' responsibility, especially if their supply of contact lenses is running low. In the case of an adverse event, a young patient should remove his contact lenses and inform a parent or notify the practitioner right away.

Finally, every contact lens patient should have a pair of spectacles with a relatively current prescription and should be prepared to wear them if necessary.

The Parents' Responsibility

Parents also have a responsibility to monitor their child's use of contact lenses. Parents should know the practitioner's recommendations and what to do in the case of an adverse event and should monitor the child to make sure the recommendations are followed. They should be prepared to make sure the child wears spectacles when contact lenses are not available or not indicated.

Educate parents about contact lens care and responsibilities along with the children. Even though children should be responsible for the daily care of their lenses, don't assume that children can assume responsibility when extenuating circumstances occur. Educate parents to call the practitioner when the child experiences problems and to anticipate annual examinations and running out of contact lenses.

Everyone Plays a Role

So whose responsibility is it? Ultimately, everyone involved has to assume a portion of the responsibility for lens wear. It's a team effort, and every member of the team plays an important role. CLS

Dr. Rah is an assistant professor at the New England College of Optometry where she works primarily in the Cornea and Contact Lens Service in patient care, teaching and research. Dr. Walline is an assistant professor at The Ohio State University College of Optometry, where he conducts studies of pediatric contact lens wear.