Prepare For Collection
Your patient is likely to be a bit nervous about having night lenses in for the first time.
They may be worried-
- The lenses will feel uncomfortable. They won’t. Using anesthetic for the application and removal appointment means they can learn and practice without lens sensation. When they are back home there is very little sensation when the eyes are closed. So once they get the lens applied they can close their eye and have no awareness.
- They won’t be able to apply or remove the lenses. Most people find this easier than expected and one appointment is all that is needed. Especially when they learn with anesthetic. Reassure them before they start that will probably be confident at it by the end of the appointment, but, if they aren’t they can use the next appointment to practice again. Night lenses will be a life long correction for them, there is no rush to get them started.
- They might be worried you are going to put your finger near their eyes. There is no need for the ECP to apply the lens. Because the vision correction with night lenses comes AFTER lens wear there is less emphasis on the lens correcting the vision. The aim of the appointment is for them to practice. Night lenses are smaller and easier to insert than soft contact lenses, so the patient can go straight to learning to apply them themselves. No one else needs to put their fingers near their eyes.
- They might think the lens can go behind their eye if they apply it wrong or rub their eye. Reassure them it can’t! Night lenses correct the vision when in, so patients will see clearly in the distance just like a day lens. When the patient applies the lens if they can see in the distance it is on their cornea and in the correct place. Lenses will centre properly behind the closed lid. Lenses won’t come off the cornea with normal lid rubbing or eye movement. And the conjunctival prevents them going behind the eye.
Prepare what you will need for the appointment.
Nocturnal lenses. New patient lenses come with mirror to help learning insertion and a sucker to help pick up dropped lenses and removal.
Anesthetic drops. If these are stored in the fridge remove them so they are at room temperature and feel less cold on insertion. Anesthetic is not essential, but they make the patient experience much more pleasant and reduce initial drop out. More info on using anesthetic is here.
Preservative-free drops. For putting a drop in the lens for applying. This avoids solution reactions and provides some comfort.
Lens care solution. This can be either MPS or peroxide that is specifically suitable for ‘hard and GP’ lenses.
Ensure the area you will be teaching the patient is clean with good lighting. Ask the patient so find somewhere similar in their home where they apply their lenses.
For all patients but especially parents, tonight might be the last time they see their kids wearing glasses! Suggest they get a video memory of the results. Take a video at bedtime of what is visible with their natural blurred vision outside, then in the morning take the same video after night lens wear.
The typical routine for the collection appointment is-
Welcome the patient, ask them if they have any questions from the brochure you gave them or if they want to know anything before you start teaching them how to care for the night lenses.
Teaching applying and removal to the first eye. Practice this a few times. Then move onto the second eye leaving the first lens in.
When the patient has both lenses in have a quick check of the fluoresceine fit, and check distance VA.
Have the patient remove the lenses. If they are confident to take them away for the first nights wear you can congratulate them on doing a good job and say you are looking forward to seeing them after the first night of wear.
✅ TASKS TO DO
- Make the patient feel at ease, reassuring them it will probably be easier than they think.
- Have lenses, anaesthetic and lens care produces ready.
- Send the night lenses video to the patient to remind them of your appointment.
- Remind the patient to get a video memory of the first night and the vision in the morning.