Contact lens solutions & other pharmaceutical products Kim Devlin FBDO [Hons] CL

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?


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!


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??]


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…


So exactly what is wrong with tap

water? You drink it don’t you??


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.


Optifree PureMoistMPDS Optifree

ReplenishMPDS

Biotrue MPS Complete

RevitalensMPDS


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


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.


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!


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.


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?



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.


Was that blue writing on a white bottle or

white writing on a blue bottle??

**** I’ll get the cheapest!


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!


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!!



Drugs which may be purchased by a DO for use in practice –Amethocaine hydrochlorideChloramphenicolCyclopentolate hydrochlorideFusidic acidLingocaine hydrochlorideOxybuprocaine hydrochlorideProxymetacaine hydrochlorideTropicamide


Drugs which may be used by CLOs in the fitting of complex contact lenses –

Lingocaine hydrochlorideOxybrupocaine hydrochlorideProxymetacaine hydrochloride


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


But what about….tissues; hand towels; cotton buds; sterile wipes; dietary supplements….not to mention dyes!

The fuss when we couldn’t get Fluorets!!


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!


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


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


Optical/ophthalmic itemsUsed or unused minims, used or unused fluoretsWaste categoryNon-hazardous pharmaceutical wasteMethod of disposalStore in a rigid leak roof containerIncinerate


Optical/ophthalmic itemsChloramphenicolWaste categoryHazardous wasteMethod of disposalStore in rigid leak proof containerSend for specialist incineration


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!


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.

Documents

Contact lens solutions & other pharmaceutical products Kim Devlin FBDO [Hons] CL