Proposed practice guidelines for continuous contact lens wear

The introduction of silicone-containing hydrogel contact lenses (SCHCLs) for continuous wear (CW) presents practitioners with a unique challenge. To facilitate the transition, we propose a set of guidelines for the conduct of CW practice. The general concepts for the guide are derived from a range of similar codes of practice that have been produced for a range of aspects of eye care. The more general competencies required of eye care practice are assumed and are not discussed in detail. The document is based on the precept that the prescription of SCHCLs is an appropriate practice for suitably screened patients. Practitioners should acquire general and specific knowledge of information applicable to CW with SCHCLs. Support staff should be educated to handle a range of requirements specific to CW. There are no consulting room facilities required beyond those necessary for general optometric practice but we highly recommend that the CW practitioner use grading scales for anterior eye complications and a guide to corneal infiltrative conditions. More stringent examination protocols are required than for general contact lens practice, particularly in the selection of the patient. Patient management should be conducted to a medical standard of care. Documentation is critical and will involve general information about the product, an agreement, disclosure of risk factors, instructions for wear and care, recording of patient questions and answers provided, an informed consent form and detailed, accurate record keeping. A guideline such as this document cannot be positioned as a legal standard of care, but may be used in the formulation of such a standard.