Evaluate procedures to increase safety and ease patient anxieties

Many procedures op- tometrists had in place pre-COVID-19 do not apply or are in need of some tweaking post-COVID-19 — at least in the short term. Of-fices may be installing slit lamp shields, new check-in procedures and frame sanitization protocols, but what should we do about our contact lens-fitting procedures?

Here are some things to consider:

1 ALLOW PATIENTS TO PUT IN THEIR OWN CONTACT LENSES

This may seem straightforward, but there were many times in the pre-COVID-19 era when either myself or a staff member would apply patients’ contact lenses for them. This would often improve the wearing experience or save time — for example, applying contact lenses for the first-time wearer. Applying contact lenses for the first-time wearer can reduce the patient’s anxiety about having contact lenses and often creates a smoother initial experience, without the struggle of inserting contact lenses for themselves. Pre-COVID-19, this would then transition to the insertion and removal training. Other times staff applying contact lenses for the patient occurs when, visually, patients are challenged with putting their contact lenses back in after an eye exam. Such patients include those who are hyperopic, multifocal wearers and those post-dilation who are struggling.

At least for the near future, I would not recommend applying anyone’s contact lenses. As with any other opening to the body, the eyes are a possible entry point for COVID-19. (See: bit.ly/covidjama .) I do not expect skipping this step to present any issues with new contact lens fits, but I would consider allowing more time for patients to learn the insertion and removal process.

2 EVALUATE YOUR PHYSICAL SPACE AND MATERIALS NEEDED

Walk through your contact lens-fitting process to determine whether any modifications to your physical space are necessary. For example, consider adding face shields at your contact lens training tables and/or exam rooms. This may help prevent any cross contamination with your patients and staff during the insertion and removal process with contact lenses.

Additionally, when patients remove their lenses during the exam, consider providing a fresh pair afterward, only utilizing disposable cases or allowing patients to keep the case their contact lenses were in. Do not try to clear and reuse those cases. This has been something we implemented at my practice a while ago, but warrants discussion at this time.

3 REVIEW SANITATION

Finally, consider reviewing your cleaning and sanitization process in the exam room and contact lens areas. Follow all CDC guidelines for cleaning and disinfection of surfaces in the exam room. And make sure to wipe any areas where patients could be using or involved with the contact lens fitting.

SAFETY FIRST

Contact lens wear is safe during the COVID-19 pandemic, but it’s a good idea to take this time to reinforce the importance of hand washing prior to handling lenses. This may also be a good time to re-fit patients into daily disposable lenses. Having a clean, fresh lens every day may ease patient anxieties and provide an improved, cleaner wearing experience from the patient’s perspective. There are no reasons to reduce the number of contact lens fittings during the post-COVID-19 era, but consider some precautions to help prevent contamination and, possibly, increase the perception of safety. OM

DR. MILLER is a partner at Eyecare Professionals of Powell, Ohio. He is past president of the Ohio Optometric Association. Dr. Miller has received honoraria for consulting, lecturing, research or acting in an advisory capacity from: Alcon, Allergan, Bausch + Lomb, J&J Vision Care, Revolution EHR and Shire.