++
6.1 Introduction to the Contact Lens Examination
6.2 Contact Lens Case History
6.3 External Examination of a Contact Lens Patient
6.4 Inspection and Verification of Soft Contact Lenses
6.5 Application (Insertion) and Removal of Soft Contact Lenses
6.6 Fit Assessment of Soft Contact Lenses
6.7 Phoropter-Based Over-Refraction of Spherical or Toric Contact Lenses
6.8 Loose Lens Over-Refraction of Spherical or Toric Contact Lenses
6.9 Evaluation of the Multifocal Contact Lens Patient
6.10 Loose-Lens Over-Refraction of Multifocal Contact Lenses
6.11 Evaluation of the Monovision Patient
6.12 Inspection and Verification of Corneal and Scleral Gas Permeable Contact Lenses
6.13 Base Curve (BC) Radius Measurement
6.14 Back Vertex Power and Optical Quality
6.15 Application (Insertion), Removal, and Recentering of Corneal Gas Permeable Contact Lenses
6.16 Fit Assessment of Corneal Gas Permeable Contact Lenses
6.17 Fit and Assessment of Orthokeratology Lenses
6.18 Application (Insertion) and Removal of Scleral Contact Lenses
6.19 Fit Assessment of Scleral Contact Lenses
6.20 Writing a Contact Lens Prescription
+++
6.1 INTRODUCTION TO THE CONTACT LENS EXAMINATION
++
The contact lens examination is an integral part of the core ocular examination. With over 45 million contact lens wearers in the United States alone, virtually all eye care providers will encounter contact lens wearers on a regular basis. Owing to the relentless growth of contact lens usage, it is essential to know the key components of a contact lens exam to ensure a maximum outcome for vision, comfort, and ocular health. This chapter describes basic procedures necessary for the fitting and evaluation of the most common contact lens types including soft and gas permeable (GP) designs. Due to their reduced prescribing frequency, some specialty lens types are beyond the scope of this chapter, though many of the basic procedures described in this chapter will apply to these lens types as well.
++
While a firm understanding of the overall structure of a contact lens exam creates a solid foundation, there will be instances when one or more side trips will be required to ensure a successful outcome. Indeed, contact lens patients have the same need for evaluation of refractive status, functional vision, and ocular health as all other patients. With this in mind, the procedures described in this chapter should be viewed as a regular part of your examination, just as your patient considers their contact lenses a regular part of their daily routine. Additionally, the procedures included in this chapter presume that the examiner is familiar with the prior procedures referenced in the text.
++
Because many providers choose to couple contact lens exams with routine comprehensive exams, this combined effort should flow seamlessly within the core ocular examination. For this to occur, you should be prepared to conduct tests that can be performed while the patient is wearing their lenses and others that should be done after the patient removes them. In general, tests requiring habitual correction, such as VA, ...