TY - JOUR
T1 - History and symptom taking in contact lens fitting and aftercare
AU - Wolffsohn, JS
AU - Naroo, SA
AU - Christie, C
AU - Morris, J
AU - Conway, R
AU - Maldonado-Codina, Carole
AU - Retallic, Neil
AU - Purslow, C
AU - The British Universities Committee Of Contact Lens Educators
N1 - BUCCLE is sponsored by Alcon, Bausch and Lomb, British Contact Lens Association, Contamac, Coopervision, David Thomas Contact Lenses, Johnson and Johnson and Sauflon.
PY - 2015/3/26
Y1 - 2015/3/26
N2 - Aims: To survey eye care practitioners from around the world regarding their current practice for anterior eye health recording to inform guidelines on best practice. Methods: The on-line survey examined the reported use of: word descriptions, sketching, grading scales or photographs; paper or computerised record cards and whether these were guided by proforma headings; grading scale choice, signs graded, level of precision, regional grading; and how much time eye care practitioners spent on average on anterior eye health recording. Results: Eight hundred and nine eye care practitioners from across the world completed the survey. Word description (p <0.001), sketches (p = 0.002) and grading scales (p <0.001) were used more for recording the anterior eye health of contact lens patients than other patients, but photography was used similarly (p = 0.132). Of the respondents, 84.5% used a grading scale, 13.5% using two, with the original Efron (51.6%) and CCLRU/Brien-Holden-Vision-Institute (48.5%) being the most popular. The median features graded was 11 (range 1–23), frequency from 91.6% (bulbar hyperaemia) to 19.6% (endothelial blebs), with most practitioners grading to the nearest unit (47.4%) and just 14.7% to one decimal place. The average time taken to report anterior eye health was reported to be 6.8 ± 5.7 min, with the maximum time available 14.0 ± 11 min. Conclusions: Developed practice and research evidence allows best practice guidelines for anterior eye health recording to be recommended. It is recommended to: record which grading scale is used; always grade to one decimal place, record what you see live rather than based on how you intend to manage a condition; grade bulbar and limbal hyperaemia, limbal neovascularisation, conjunctival papillary red- ness and roughness (in white light to assess colouration with fluorescein instilled to aid visualisation of papillae/follicles), blepharitis, meibomian gland dysfunction and sketch staining (both corneal and con- junctival) at every visit. Record other anterior eye features only if they are remarkable, but indicate that the key tissue which have been examined.
AB - Aims: To survey eye care practitioners from around the world regarding their current practice for anterior eye health recording to inform guidelines on best practice. Methods: The on-line survey examined the reported use of: word descriptions, sketching, grading scales or photographs; paper or computerised record cards and whether these were guided by proforma headings; grading scale choice, signs graded, level of precision, regional grading; and how much time eye care practitioners spent on average on anterior eye health recording. Results: Eight hundred and nine eye care practitioners from across the world completed the survey. Word description (p <0.001), sketches (p = 0.002) and grading scales (p <0.001) were used more for recording the anterior eye health of contact lens patients than other patients, but photography was used similarly (p = 0.132). Of the respondents, 84.5% used a grading scale, 13.5% using two, with the original Efron (51.6%) and CCLRU/Brien-Holden-Vision-Institute (48.5%) being the most popular. The median features graded was 11 (range 1–23), frequency from 91.6% (bulbar hyperaemia) to 19.6% (endothelial blebs), with most practitioners grading to the nearest unit (47.4%) and just 14.7% to one decimal place. The average time taken to report anterior eye health was reported to be 6.8 ± 5.7 min, with the maximum time available 14.0 ± 11 min. Conclusions: Developed practice and research evidence allows best practice guidelines for anterior eye health recording to be recommended. It is recommended to: record which grading scale is used; always grade to one decimal place, record what you see live rather than based on how you intend to manage a condition; grade bulbar and limbal hyperaemia, limbal neovascularisation, conjunctival papillary red- ness and roughness (in white light to assess colouration with fluorescein instilled to aid visualisation of papillae/follicles), blepharitis, meibomian gland dysfunction and sketch staining (both corneal and con- junctival) at every visit. Record other anterior eye features only if they are remarkable, but indicate that the key tissue which have been examined.
U2 - 10.1016/j.clae.2015.03.002
DO - 10.1016/j.clae.2015.03.002
M3 - Article
SN - 1367-0484
VL - 38
SP - 258
EP - 265
JO - Contact Lens & Anterior Eye
JF - Contact Lens & Anterior Eye
IS - 4
ER -