Continuing education CET

● Tear film assessment should be undertaken with minimal invasion of the structure – non-invasive techniques should be used whenever possible ● Assessment must be made both prior to and during contact lens wear. Tear film quality should be assessed both with the lens in situ and without the lens ● Use of the Tearscope in clinical practice allows a more detailed examination of the tears to be undertaken ● Symptoms, not just signs, are an important aspect of overall tear film assessment Soft contact lenses continue to dominate most contact lens markets, accounting for about 90 per cent of all fits worldwide.1 Options available to the practitioner continue to evolve in lens materials, designs and replacement frequencies. Although hydrogel lenses continue to dominate, prescribing of silicone hydrogel lenses is increasing, accounting for almost one-quarter of soft lens fits globally. As efforts to improve patient satisfaction and longterm contact lens success continue, attention to lens selection and optimisation of fit should not be ignored. Although there are fewer parameters to consider when fitting soft lenses, it is still of upmost importance to assess fit accurately. Prescribing the right material, lens dimensions and wearing modality to match a wearer’s ocular topography and lifestyle, should be the goal of every contact lens practitioner. Sub-optimal fit or inappropriate lens selection can result in discomfort and/or have potential physiological impact, which can contribute to contact lens wear discontinuation.2 Experiences with the first generation higher modulus silicone hydrogel lenses remind us of the importance of optimal fit. It has been argued that the skill in contact lens practice has moved from the mechanics of lens fitting to monitoring the ocular physiology of the patient. nowhere is this truer than in soft lens fitting, where options available to practitioners are often limited to a ‘one-fit’ lens design. Although one-fit lenses may achieve a high percentage of acceptable fits, understanding how to assess and optimise lens fit remains key. Many myths surrounding soft contact lens fitting and design have been summarised in the literature.3 This article provides a practical overview of the key aspects of soft contact lens fitting principles. It does not deal with specific products. All the rules that apply to hydrogel lens fitting also apply to silicone hydrogel materials.