– Ed

When an optometrist takes on a patient and fits her with contact lenses, by law, he also assumes responsibility for her corneal health. He will assess her corneal health prior to fitting the contact lenses and will do so every time she comes in for a follow up consultation. If there are any concerns about her corneal well-being, he may request more frequent follow-up visits.

When a patient who has not been seen by the optometrist and no patient record exists, walks in and request to buy contact lenses, the optometrist is required by law to assume responsibility for her ocular health. The correct procedure is for the optometrist to do a quick biomicroscope examination to rule out any corneal issues.

The cornea is avascular, meaning it has no blood vessels to carry oxygen. It gets its oxygen from the atmosphere. An optometrist, will ensure that a contact lens is fitted in such a way, that enough oxygen still reaches the cornea. With a soft contact lens, the oxygen can permeate through the lens material and with a rigid contact lens, the lens moves with blinking and pumps tears (carrying oxygen) under the lens.

Wearing contact lenses long term, without regular follow-up checks is not wise. When the cornea is compromised, due to insufficient oxygen reaching it, neo vascularization may occur. These are new vessels that start to grow into the cornea and can cause problems. Another risk factor with soft lenses is developing Giant Papillary Conjunctivitis. This can result from over wearing contact lenses or wearing dirty lenses among other things. Once you develop GPC, the lenses tend to be pulled up by the rough papillae under the lids (see picture). It is very difficult to get rid of GPC once you develop it, and it may result in terminating contact lens wear.

When purchasing contact lenses from an optometrist who has not seen you before, your corneal health has to be checked out. Frequently, this results in a heated debate at the front desk. Most optometrists will do this check pro Deo (although entitled to charge a fee).

Doing the right thing is always right!

Bumps under the top lid – GPC
Neo vascularization
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