contact lens solutions & other pharmaceutical products kim devlin fbdo [hons] cl
Post on 23-Dec-2015
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Contact lens solutions & other pharmaceutical
productsKim Devlin FBDO [Hons] CL
Contact lens solutions
Core competencies for Optometrists, CLO and Dispensing Opticians all state
the same thing.To be competent we all have to
understand the care of all types of CLs, the only difference is the detail
Contact lens solutionsFamiliarity breeds contempt!
We are all guilty of using a brand or type of solution because we’ve always done so….or
it’s company policy.Regular rethinks on which solution is right
for each patient or product are necessary – it’s one of the reasons we have aftercare
appointments. Is the solution as good as it can be and is it being used correctly?
Contact lens solutions
It feels that we fit only daily disposable soft lenses all day, we have
such a choice of lenses in that modality. But consider those patients
who need monthly or 2 weekly disposable lenses or, whisper it, Gas
Permeable rigid!
Contact lens solutions
Is H2O2 still the gold standard?Modern MPS are all good bug killers, the
difference is only in the additives – do you know which product is good for which lens
material?If a patient reacts badly to product ‘B’ what
would be a reasonable alternative - product ‘C’ or ‘D’? [or X or Y??]
Contact lens solutions
Each product have their own plus points but also each has their own minus points!You can usually rely on competitors to tell you the minus ones!Truly, whichever one you decide, in your professional opinion, to advise your patient to use, it doesn’t matter as long as you have an acceptable alternative.Always assuming the patient can be trusted to comply…
Contact lens solutions
So exactly what is wrong with tap
water? You drink it don’t you??
Contact lens solutions
What is the best solution to use?In the highly technical field of polymer chemistry the average practitioner cannot hope to know all the chemical formulae of each and every product.But all of us should take the time and trouble to know what new products have been introduced and what each manufacturer claims the advantages are of their product.
Contact lens solutions
Optifree PureMoistMPDS Optifree
ReplenishMPDS
Biotrue MPS Complete
RevitalensMPDS
Contact lens solutions
It is a partnership, lens materials and solutions and patient.
If the patient sees your careless attitude to solution choice they will assume any old solution
will do and buy their supplies at the nearest supermarket.
Explain why a product is good for their lenses and their eyes. If any brand is OK in your opinion
– tell them so, they appreciate honesty
Contact lens solutions
There are Optometrists who hate CL, don’t want anything to do with them, never fit them and try never
to recommend them.The bad news for them is, CL are here to stay, the GOC
requires you to understand their care and maintenance, regardless.
Your attitude will make patients think all products are the same – it doesn’t matter.
Well it does matter! Successful CL wear relies on good care from all the practice team.
Contact lens solutions
If you choose not to fit CL that’s fine but you will still encounter patients who wear them to their
eye examination….You have to have CL cases/solutions for lenses to be stored temporally and appreciate that not all lenses can be reinserted after stain or drops, and possibly issue daily disposable lenses to get the patient home if they forgot their specs – as they
do!
Contact lens solutions
There are some very smug CLOs sitting out there; they feel they are specialists – it’s
what they do all day, they know it all!You too have your own prejudices, a
product you use without consideration, it’s too easy to simply give the starter pack you always do without considering if something
new might, just might, be better.
Contact lens solutions
And what about the DOs here tonight?What does it have to do with you?
Everything! What do you recommend when a patient asks ‘can I put my lenses back in to look
at frames?’Is it a monthly lens, what solution was it stored in? Will that fetching green dye encourage the
patient to choose a designer frame or will it make everything look awful?
Contact lens solutions
Contact lens solutions
What about the casual drop in customer who wants to buy a bottle of solution?
Can you advise them? Should you advise them?
You have to be able to recommend the right product for each customer and
equally supervise your non professional staff in such sales as well.
Contact lens solutions
Was that blue writing on a white bottle or
white writing on a blue bottle??
**** I’ll get the cheapest!
Contact lens solutions
Who does the buying? Do you decide what solution will be stocked on the shelves?
Who checks that sales are worth the outlay of discarded, out of date stock?
Who ensures there are starter packs in the consulting room? [Once the perk of all the staff] now like gold dust, carefully allocated
with the supply of products
Pharmaceutical products
How many of you are thinking already..
What’s this got to do with me? I don’t use the things…I don’t even know how to pronounce half of them!
Pharmaceutical products
Optometrists here tonight will be familiar with all the products they need for their work in practice, rarely a day goes by without one Minim or other being used….
But do you all think about where they come from, how they miraculously appear in your cupboard and in date as well!!
Pharmaceutical products
Pharmaceutical products
Drugs which may be purchased by a DO for use in practice –Amethocaine hydrochlorideChloramphenicolCyclopentolate hydrochlorideFusidic acidLingocaine hydrochlorideOxybuprocaine hydrochlorideProxymetacaine hydrochlorideTropicamide
Pharmaceutical products
Drugs which may be used by CLOs in the fitting of complex contact lenses –
Lingocaine hydrochlorideOxybrupocaine hydrochlorideProxymetacaine hydrochloride
Pharmaceutical products
Chloramphenicol can be used in the case of acute bacteriological conjunctivitis only –
• A maximum pack of size of 10ml [drops] or 4mg [ointment]
• Only in adults and children over 2 years of age• For a maximum of 5 days
Pharmaceutical products
But what about….tissues; hand towels; cotton buds; sterile wipes; dietary supplements….not to mention dyes!
The fuss when we couldn’t get Fluorets!!
Pharmaceutical products
An Optometrist in practice uses all manner of products, Minims certainly, but other perhaps more mundane
items like tissues, cotton buds or paper towels.
Who buys them? Who decides what brand? Who checks the date and disposes of the waste appropriately?
Someone has to, and you have a professional responsibility to ensure everything is done correctly.
As do CLOs!
Pharmaceutical products
Yes, the gripping saga of…….WASTE DISPOSAL!!
Section 34 of the Environmental Protection Act 1990 states that waste disposal must be safe,
environmentally sound and legal
Pharmaceutical products
Optical/ophthalmic itemsEmpty CL solution bottlesTonometer probesLarge quantities of CLs [eg time expired bank lenses]Waste categoryNon-hazardous healthcare wasteMethod of disposalPlace in tiger bags [yellow/black striped bags]Dispose of in the offensive waste stream
Pharmaceutical products
Optical/ophthalmic itemsUsed or unused minims, used or unused fluoretsWaste categoryNon-hazardous pharmaceutical wasteMethod of disposalStore in a rigid leak roof containerIncinerate
Pharmaceutical products
Optical/ophthalmic itemsChloramphenicolWaste categoryHazardous wasteMethod of disposalStore in rigid leak proof containerSend for specialist incineration
Pharmaceutical products
You might work in many different practices but you are still responsible for the standards of hygiene in
the consulting room when you’re there.Patients pick up information almost by telepathy, they see you wash your hands, they wash their
hands, they see you leave the top off the solution bottle they will too.
The standard you set in practice, be it rinsing a contact lens case in tap water or huffing on a
spectacle lens before you rub it, will be copied!
Contact lens solutions
So, we’re all in this together!Whatever your thoughts on CL they, and
their care products, are an intrinsic part of everyday practice.
You might wish to let the Internet sites and supermarkets have the profits from solution sales but it is nigh on impossible to practice today without knowledge of these products.
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