The College of Optometrists

Question about Flurescien use in the aftercare section of final contact lens exam.

Useualy as part of slit lamp routine in an aftercare NaF would be instiled to check for corneal staining etc. with soft lens wearers you would get the Px to remove lens before this and advised not to reinsert for at least an hour or so so that NaF does not get absorbed into lens.

How does this work in the final assesment because surly the patient will have to reinser their lens for the next student to assess. if they are softlens wearer particularly if not frequent replacement lens this could be a problem.

Also a very quick and easy question do we have to perform an overrefraction at any stage of the contact lens exam

-they can wash the flouescein out with saline.

Yes -overrefraction is part of an aftercare and a fit. (you can save time by having a little peep with your ret.

Stephen- are you sure? I was under the understanding that overrefraction results were provided...

Stephen is right you would normally do an over refraction as part of your contact lens aftercare, however for the PRP final exam it specifically states in the candidates guidance notes that you do not have to do an over refration. This is purely because of the limited time available.

Patients are assessed on only one eye in the aftercare exam, therefore it is perfectly acceptable (in fact absolutely essential) that you assess with flourescein. Patients can then be assessed for the other eye by the next candidate.

All this information is in the pre-registration handbook and the guidance notes. I would suggest reading them with care. The new Pre-registration handbook 2007, available on this website is even more comprehensive and clearer than the last.