25. Working with the patient to minimise their risk of harm

What do you do if a contact lens patient refuses to follow your advice?

Scenario

Bipasha Basu, aged 39, comes to you for a routine contact lens aftercare appointment. She has worn monthly disposable contact lenses full time for the last 21 years and has had no problems with her eyes or contact lenses. Her last check up with you was one year ago. At that visit you noted that Bipasha is a keen swimmer and advised her not to wear her lenses while swimming. Today, your findings are again normal and she is still not having any problems with her vision or contact lenses. However, when discussing her wearing regime, she tells you she has occasionally lost lenses while swimming or showering in her contact lenses. You once again advise her of the risks associated with showering or swimming in her contact lenses. She tells you that although she understands your advice, she has worn lenses for many years without problems and she will continue to wear her lenses whilst swimming or showering. She is on her last pair of lenses, and asks you if she can purchase some more from you.

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