Contact lens solutions other pharmaceutical products Kim Devlin

Contact lens solutions & other pharmaceutical products Kim 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 solutions Familiarity 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 H 2 O 2 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 Pure. Moist MPDS Biotrue MPS Optifree Replenish MPDS Complete Revitalens MPDS

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 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 hydrochloride Chloramphenicol Cyclopentolate hydrochloride Fusidic acid Lingocaine hydrochloride Oxybuprocaine hydrochloride Proxymetacaine hydrochloride Tropicamide

Pharmaceutical products Drugs which may be used by CLOs in the fitting of complex contact lenses – Lingocaine hydrochloride Oxybrupocaine hydrochloride Proxymetacaine hydrochloride

Pharmaceutical products Chloramphenicol can be used in the case of acute bacteriological conjunctivitis only – • A maximum pack of size of 10 ml [drops] or 4 mg [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 items Empty CL solution bottles Tonometer probes Large quantities of CLs [eg time expired bank lenses] Waste category Non-hazardous healthcare waste Method of disposal Place in tiger bags [yellow/black striped bags] Dispose of in the offensive waste stream

Pharmaceutical products Optical/ophthalmic items Used or unused minims, used or unused fluorets Waste category Non-hazardous pharmaceutical waste Method of disposal Store in a rigid leak roof container Incinerate

Pharmaceutical products Optical/ophthalmic items Chloramphenicol Waste category Hazardous waste Method of disposal Store in rigid leak proof container Send 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.