Case study: You are a contact lens fitter and an automated refracting optician. Mike, a 39-year-old patient, came to your dispensary. He is visiting Vancouver for two months. He said that he needs disposable contact lenses as he did not have time to replenish his supply before he left for Vancouver. He produced a one-year-old prescription issued by an Icelandic optometrist.
What can you do? There are various steps that you can do to help Mike.
Assess the nature of the situation:
- Is it an emergency?
- Is it temporary?
Identify any risk of harm to Mike if you dispense the contact lenses based on his prescription.
- Has he had any issues wearing contact lenses before?
- Has there been any change in his vision within the past year?
Also, ask the question – If you don’t dispense the contact lenses would that pose a greater risk of harm to Mike?
Do a slit lamp observation of the corneal surface.
If Mike is willing to have you conduct a sight-test on him then you can do that as another step before trial fitting the contact lenses.
If there are no vision/health issues that would prevent you from dispensing the contact lenses:
- Proceed with the trial fitting, and follow the fitting/dispensing schedule according to the Standards of Practice.
- Advise Mike that this is a one-time emergency dispensing and that he has to have an eye exam if he requires additional supply beyond two months.
- Record the emergency dispensing in the patient file and possible future check-ups, if available.
- If there are issues that you think will result in risk of harm for Mike (example, significant change in prescription for last 6 months), you can recommend that he see a local optometrist. Or at least have him agree to be sight-tested. If he refuses to either, it is your discretion as a licensed optician to assess the risk of harm to Mike. You can refuse service and provide reasons for doing so.
- The steps above are the same for a patient who presents you a prescription from other countries. The most important factor to consider is whether all the required information is recorded on the prescription to dispense the contact lenses. You might take this for granted, but opticians go through a lot of critical decisions when dealing with patients. The Standards of Practice document available from the COBC website provides the minimum standards expected from opticians.
Would you have done something differently? Feel free to contact us, we would be glad to discuss it with you!