Registrant-led peer discussion cases

Case booklet and guidance

Contact lens cases

Association of British Dispensing Opticians

Contact lens cases

Target Groups Setting up a peer discussion group in

your practice

Suitable for: 1. Go to your MyCET webpage and click on

‘Setup Peer Review Group’ in the left menu.
Contact Lens Opticians
2. Complete your peer review group description.
Dispensing Opticians 3. As shown on the opposite page; complete the
5 steps for each learning objective, using the
Optometrists numbering and learning objective text from this
booklet. Remember to ‘Save’ after each one.

Participant name:
Important:
• You can only apply for a group of 4 to 10
participants.
• CET approval must be gained before the
session – there is NO post-approval.
GOC number: • Give each participant a copy of this booklet
to make notes and retain.
• Summarise briefly and note the outcome of
the group’s discussions for each case.

Date: For an expanded description of the approval

application process, go to:-
http://www.abdo.org.uk/wp-
content/uploads/2013/06/Setting-up-a-Peer-
Review-Part-1.pdf
(Member log-in required)

Paperwork needed for the session:

Enough booklets for each participant.
Sign-in sheet from the GOC website:
https://www.optical.org/download.cfm?docid=9EB
26EE1-2238-4C57B50EFC2CB7B4CA8F

Association of British Dispensing Opticians

B

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Contact lens case set L
m
c

L
d
s
p

Competencies Learning Objectives L

c
CLO CLO a
1. Communication
LO: 1.2.1 Can explain the limitations of D
contact lens correction for presbyopes in 1
clear and understandable language L
2. Standards of Practice c
LO: 2.1.5 Uses patient behaviour and c
preferences to assist advice given to CL 2
patients and inform subsequent L
management plan a
Dispensing optician LO: 2.6.4 Demonstrates knowledge of the C
advice and guidance set by ABDO, the k
College of Optometrists and the GOC and t
knowledge of the Opticians Act with regard L
to contact lens practice c
LO: 2.8.1 Is able to produce CL records using r
understandable terminology to record L
Optometrist patient details, measurements, results and r
advice. Knows what must be included in a p
contact lens record.
4
3. Methods of ocular examination L
LO: 3.2.2 Can interpret the results of a slit- o
lamp examination noted in patient records. p
Understands the use of grading scales. w
4. Verification and identification i
LO: 4.2.1 Can describe and distinguish 5
between contact lenses designed for L
presbyopia. l
5. Contact lenses U
LO: 5.5.2 Understands the various options for l
the management of presbyopia: specs v. L
CLs. Can describe the designs of CLs a
suitable for the management of presbyopia. a

Association of British Dispensing Opticians

LO: 5.1.1 Knows the range of soft lens
materials and designs available when
considering a new patient's requirements.
LO: 5.3.2 Knows the advantages and
disadvantages of contact lenses v.
spectacles and can apply them to a
patient's situation.
LO: 5.3.1 Can interpret a record of the
content and routine for a soft lens aftercare
appointment.
Dispensing Optician
1. Communication
LO: 1.2.1 Can explain the limitations of
contact lens correction for presbyopes in
clear and understandable language.
2. Standards of practice
LO: 2.6.4 Demonstrates knowledge of the
advice and guidance set by ABDO, the
College of Optometrists and the GOC and
knowledge of the Opticians Act with regard
to contact lens practice
LO 2.8.1 Can understand the terminology in
contact lens records for all measurements,
results and advice.
LO: 2.10.1 Understands the roles and
responsibilities of other professions within the
practice team
4. Optical appliances
LO: 4.1.2 Can suggest appropriate PPL or
other lens selection with justification to the
patient’s requirements. Can problem-solve
when lenses have been dispensed
inappropriately.
5. Contact Lenses
LO: 5.1.1 Knows the advantages and
limitations of contact lenses v. spectacles.
Understands the differences in the contact
lens management of presbyopia
LO: 5.2.1 Understands the importance of
appropriate wearing schedules and regular
aftercare visits
Optometrist
1. Communication
LO: 1.2.1 Can explain the limitations of
contact lens correction for presbyopes in
clear and understandable language.
2. Standards of Practice
LO: 2.1.5 Uses patient behaviour and
preferences to assist advice given to CL
patients and inform subsequent
management plan
LO: 2.6.4 Demonstrates knowledge of the
advice and guidance set by ABDO, the
College of Optometrists and the GOC and
knowledge of the Opticians Act with regard
to contact lens practice
LO: 2.8.1 Is able to produce CL records using
understandable terminology to record
patient details, measurements, results and
advice. Knows what must be included in a
contact lenses record.
LO: 2.10.1 Understands the roles and
responsibilities of other professions within the
practice team
4. Optical appliances
LO: 4.1.5 Can suggest appropriate PPL or
other lens selection with justification to the
patient’s requirements. Can problem solve
when lenses have been dispensed
inappropriately.
5. Contact Lenses
LO: 5.1.1 Demonstrates an understanding of
the range of soft lens materials and designs
available
LO: 5.3.2 Understands the various options for
the management of presbyopia: spectacles
v. CLs. Can describe the designs of CLs
suitable for the management of presbyopia.
Your discussion of the four cases must last at least
one hour. You must discuss all four to cover the
competencies and achieve the learning
objectives. A list of references is provided for further
study at the end. These can also be accessed
during the session to support the discussion.
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Association of British Dispensing Opticians
Contact lens
Case 1 - New contact lens wearer

Suggested discussion topics

• Is there a legal requirement for the eye-examination

date to be checked and recorded?

• Content of initial history

• Measurements

• Other clinical tests

• As patient will be an infrequent wearer, does it matter

if there is no full record of fit and lens behaviour?

• When do you usually schedule the first follow-up

appointment?

NOTES:

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Contact lens
Case 2 - Contact lenses and occupational dispensing

RIGHT LEFT

Sphere Cyl Axis Prism Base Sphere Cyl Axis Prism Base

Distance -2.25 -0.25 180 Distance -2.50 -0.25 170

Reading Add +1.25 Reading Add +1.25

NOTES: VA 6/6+ N4.5 R&L

Patient details

Mrs A B - Age 47 (Driver)

Occupation: Secretary
Hobbies/Sports: Gym & Walking
General health: Good, no medication

Lenses: Varilux Comfort Short PPLs

Long-term contact lens wearer, currently

wearing Acuvue Oasys 2 x month disposal.

R -2.25 6/5 L -2.50 6/6

(Using +1.00 ready-mades N4.5)
Suggested discussion topics
Also trialling: Acuvue Oasys for Presbyopia
Spectacles
R -2.25 Low add L -2.50 Low add
• Choice of PPL
After 2 weeks trial patient complains of
• Other dispensing options
reduced DV + NV in new contact lenses.
R 6/6 VA 6/6 N6 L 6/7.5 N8
Contact lenses
Mrs AB likes her varifocal spectacles
• What design is an Oasys Presbyopic
but finds them difficult when using the
contact lens?
computer at work. She is reluctant to
stop wearing contact lenses, but finds • Other multifocal CL designs &
reading spectacles over the contact materials
lenses a problem. • Other CL management options

Association of British Dispensing Opticians

NOTES:

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Contact lens
Case 3 - Contact lens supply

Patient details
Miss Cookson, 28, comes in for a You have overheard all this, and
contact lens check-up, and to collect examine the record: Miss Cookson
her contact lenses. wears 1-Day Acuvue TruEye (-2.00 R&L)
on a 30 pairs every 2 months delivery
Miss Cookson arrives 30 minutes late
schedule and hasn't had a check-up or
for her 4.40pm appointment on Friday
a sight test for 18 months. Her recall for
afternoon. The CL practitioner, Mr King,
both eye exam and contact lens
waited 20 minutes for her, but with no
aftercare is 12 months.
phone call from the patient to say
whether she was coming or not, he
left at his usual time of 5pm.

Miss Cookson is very apologetic but

asks if she can take her lenses anyway
as she is going skiing for 7 days the
following morning and has only got a
couple of pairs of lenses left at home.

At this point the receptionist says that

as it's been over 12 months and she is
sorry but she can't issue any lenses until
Miss Cookson has had a check-up.
Miss Cookson then gets very annoyed
indeed, saying that she has paid for
the lenses and they are her property,
that her eyes are perfectly fine and Suggested discussion topics
she doesn't need a check-up, and if
• What would you do?
she doesn't get her lenses she will hold
you responsible for the full cost of her CLOs, DOs and optometrists may all
holiday of she is unable to take it. have a different approach to this

Association of British Dispensing Opticians

NOTES:

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Association of British Dispensing Opticians
Contact lens
Case 4 - CL overwear?

Patient details NOTES:

22 year old male patient has attended
for a regular 6 month aftercare. He was
fitted for the first time in August 2017 with
budget 1-day lenses to use at the gym
twice a week. He has subsequently
attended for a 2 week and 3 month
aftercare where vision was good, eyes
appeared healthy and the patient was
happy with his lenses.

Since his last aftercare the patient has

increased his wear times, he is attending
the gym more frequently and feels good
about his appearance. He has misplaced
his spectacles but hasn’t replaced them
as he prefers wearing his contact lenses.

See today’s contact lens aftercare case

record opposite…

Suggested discussion topics

• How could you improve this record?

• Has the practitioner responded

appropriately to the information that
they have gathered?

• Is the practitioner’s advice

appropriate?

• How would you explain the necessity

for spectacles as well as CLs?

• Should the patient be refitted, and with

what? If a perfect solution is not
possible, how do you communicate
this to the patient?

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Contact lens case set
Peer discussion reflective learning statement

Following your discussions, please list what you have learned, where your knowledge has
been reinforced, any helpful tips you have picked up, and any topics you may wish to
research further.

When you accept your CET points on MyCET after the session, you must complete a
similar reflection statement, therefore you are strongly advised to retain this booklet.

1. Summarise the clinical skills and competencies that were discussed during this session:

2. List the main things you learned from this session:

3. Describe how you will apply this learning in your practice:

4. Has this session identified any areas where further personal learning is needed?
If so briefly describe these below:

Association of British Dispensing Opticians


After the discussion…
Participants should complete the
reflective learning statement to
keep.
Within 10 days of the discussion, the
lead registrant must visit MyCET to
upload the cases discussed, some
notes about the discussion
outcomes from the group, via the
‘Make Declaration’ button. You
can then upload the names and
GOC numbers of the participants
from the attendance sheet.
More detailed information on this
can be found at
http://www.abdo.org.uk/wp-
content/uploads/2013/06/Setting-
up-a-Peer-Review-Part-2.pdf
Resources
ABDO’s Advice and Guidelines.
Section 3: Contact Lens Practice
www.abdo.org.uk/advice-guidelines
ABDO FAQs 2015:
Handing out contact lenses
http://www.abdo.org.uk/frequently-asked-questions
/faqs-2015/
The College of Optometrists
Code of Ethics and Guidance for
Professional Conduct
http://guidance.college-optometrists.org/guidance-
contents/
Search in A-Z directory for:-
Contact lens aftercare
Contact lens check-ups
Contact lens extended wear
Contact lens fitting
Contact lens specification
Contact lens supply
Johnson & Johnson Visioncare
http://www.acuvue.com/products-acuvue-oasys-for-
presbyopia
CLs for presbyopia (2010)
http://www.reviewofophthalmology.com/content/i/13
52/c/25849/
Occupational Dispensing (ABDO 2017)
http://www.abdo.org.uk/wp-content/uploads/
2012/06/Occupational-dispensing-0617.pdf
Complete Course in Dispensing (Optician 2008)
Part 6 Lens Selection
http://assets.markallengroup.com/article-images
/image-library/147/uploads/importedimages/
dispensing-part-6.pdf
You can also make use of search engines to find
resources from reliable websites.
CAUTION: there is good information on the
internet, but you will also find opinions,
misconceptions, and inaccurate information.
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ABDO CET
5 Kingsford Business Centre, Layer Road
Kingsford, Colchester CO2 0HT
Telephone 01206 734 155
Fax 01206 734 156
January 2018

General CET enquiries abdocet@abdo.org.uk

Regional CET event enquiries events@abdo.org.uk

© Association of British Dispensing Opticians