Dispensing off Boxtops

Case study: You are a contact lens fitter with a busy practice. Maria visited your dispensary for the first time to order a refill of her soft contact lenses. 
She presented you with the box top of contact lenses that she has been using for the past year. She said she liked the brand and did not have any problem using the contact lenses. She also said that she had her last eye exam 8months ago.
Question: Can you dispense using information from the box top?
1. For first time patients, you should not order contact lenses without checking the cornea and having/creating a contact lens record. 
Every time you get a new patient, you don’t know anything about them until you start collecting information and assessing them. You need to understand what kind of professional care your patient needs. While someone can claim everything is fine, you have the professional knowledge, skills, and tools to help confirm that opinion.
2. For current patients, you should periodically check for any changes before refilling contact lenses. 
Contact Lens Record
In addition, eye care professionals are required to provide contact lens record,free of charge to the patient. It should not be difficult for a patient to get a copy or have you request a copy on their behalf after receiving consent for its release.
Can the patient provide you a copy of the contact lens record?  This record contains contact lens specifications derived from fitting a contact lens.
  • Maria responded that she did not remember getting a copy.
  • You can tell Maria that optometrists and contact lens fitters are required to provide patients with the contact lens record, free of charge.
  • You can suggest asking a copy on her behalf, as long as she provides you consent for its release. 
Assess the patient’s needs 
  • Has Maria had any issues relating to wearing contact lenses?
  • Are there vision or health issues preventing you from dispensing the contact lenses?
  • Ask if you can do a slit lamp observation of the corneal surface and explain the benefits to Maria.
You can dispense after assessing the cornea and receiving a copy of the contact lens record.
Document advice to patient. 
  • Maria is your patient once you accept and fulfill the re-order.
  • Advise Maria that an independent assessment of fit is to her benefit.
  • Inform Maria of any potential negative wearing effect at the time of dispensing.
  • Advise Maria of any follow-up assessment required.
  • Document this advice on the patient’s record.
If you have any questions regarding this case study or you need support with any other situation where you wasn’t sure what to do, feel free to contact us by email or phone