Contact Lenses

CL Patient in Your Exam Chair: Apply Lenses for Them

By Brian Chou, OD, FAAO

I am surprised by how frequently new patients remark that they never had another doctor apply or remove contacts for them during examination.

Apparently, many of us eye doctors allow our patients to handle contacts themselves during contact lens evaluation and prescribing.

Early in my career, I routinely had my patients apply and remove contact lenses themselves. I rationalized that I could catch up on chart recording while the patient dealt with the lenses. Perhaps patients liked it better, too.

I changed my ways after asking one patient to apply lenses herself. It took over five minutes, and to boot, the lenses ended up switched with one lens inverted and cracked. No doubt, my good intentions backfired. Ever since, I typically perform application and removal myself, or have one of my staff assist.

Here are reasons why you–not the patient–should handle contacts in the exam room:

• You are faster at application and removal than most patients.
• You are unlikely to switch the right and left lenses.
• You are unlikely to apply the lens inverted.
• You are more hygienic. Some patients will not wash their hands prior to lens handling.
• You are less likely to introduce debris under the contact lens. This maximizes initial lens comfort and a positive first impression.
• You minimize the settling time of toric lenses. Some patients apply toric lenses without paying attention to the laser marking placement.

The bottom line is that you are better at contact lens handling than most of your patients. Your greater efficiency allows you to spend more chair time educating the patient about their eyecare. Consistent with this premise, you should routinely perform application and removal while the patient sits in the exam chair. Better yet, delegate this task to properly trained staff when it saves you time.

There are only a few occasions during an exam when I might have the patient apply or remove lenses on their own. The first is if I wish to review the patient’s handling technique. The second is when I believe I may have a contagious upper-respiratory infection. The third is when the patient insists on doing it on their own.

Do you or a staff member apply contact lenses for the patient while they are in your exam chair, or do you leave that to the patient? Why?

Brian Chou, OD, FAAO, is a partner with EyeLux Optometry in San Diego, Calif. To contact him: chou@refractivesource.com.

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