The teaching area should have a table where the instructor sits facing the patient. There should be a mirror, a tray and some lint free tissue papers on this table. The complete range of solution bottles should be at hand. The washbasin should also be at a convenient distance.
Soft Contact Lenses Instructions
The First Basic Step: Wash Hands
Insertion Technique
Step 1: Patient grasps the upper lid with left hand (non-dominant hand), pulls down the lower lid with middle finger of right hand and holds the lens on the index finger of this hand. (Grasp the upperlid at the lid margin, not above it; else the lids will close by reflexblinking).
Step 2: The finger holding the lens should be dry. Allow the lens to alsoair dry slightly before insertion.
Step 3: The patient brings the lens up, looking in the mirror. The lens will self-center with a blink or two, so it has not to be placed directly on to the cornea. More pressure has to be applied to the lens in order to adhere to the eye.
Step 4: Once the lens is inserted, have him or her look down beforereleasing the lids to prevent the lens from being blinked out.Release the lower lid slowly followed by upper lid.
Removal Technique
Step 1: Check the lens is on place and that it does not feel dry. In case recenter it andinstill lubricating drops to rehydrate.
Step 2: Have the patient look up securing the upper lid with the lefthand (non-dominant hand) and the lower lid with the right handor the dominant hand.
Step 3: Using the index finger, of right hand have the patient slide thelens down and out onto the sclera.
Step 4: Once the lens is onto the sclera, tell them to use their thumband index finger to pinch the lens off the eye
RIGID LENS INSERTION AND REMOVAL
Basic Step—Wash Hands
INSERTION TECHNIQUE
Step 1: Take the left hand over your head and bring it upper eyelidmargin and eyelashes holding it securely to the orbital bone.The tight gasp is important.
Step 2: The index finger of the right hand holds the lens and the middlefinger pulls down the lower lid.
Step 3: The patient brings the lens up, looking in the upright mirror.Tell the patient to look through the lens and place the lens directlyon the cornea.
Step 4: A light touch is needed for the lens to be inserted. The patientshould be instructed to keep looking through the lens else thelens will not center on the cornea.
Step 5: Look down release the lower lid first then the upper lid.
Step 6: If displaced teach recentration. Teach the patient to relocate thelens by using two fingers against the lid margin and sliding thelens towards the cornea.
Other method of recentration
Feel the lens with the fingers. With the index and middle fingerof the dominant hand hold the lens. Holding the lens, look inthe opposite direction of the lens. Push the lens towards thecornea hold the lens in the center. Don’t release the hand. Lookstraight. The cornea will automatically slide under the lens.Release the hand.
Removal Technique
Step 1: Check the lens is in center.
Step 2: Patient has to open his eye wide as possible, have him turn the
face so that cornea is slightly nasal in the palpebral opening.
Step 3: Point out the index finger only; roll the other 3 fingers first. Placethe index finger of the right hand for right eye, on the outercanthus, elbow pointing straight.
Step 4: Pull up and out, and then forcefully blink. Don’t release theforce till blink. The lid margins will catch the edge of the lensand the lens will pop out.
Step 5: Remember to put the other hand below to catch the lens.
Using two fingers:
- With the index fingers of both hands, hold the upper andlower lens edges at the widest points of lens edge.
- Gently push the lower lid upwards, inwards and towardseye, and at the same time push the top lid downwards sothat both the lid margins engage lens edges. This enablesthe lens to slide over the lower lid and out of eye. The lenswill now be positioned on the nail of index finger.
- Hold the lens with adjacent finger to prevent it from falling
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