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Contact lenses are artificial devices applied on the eye's front surface to substitute for the anterior corneal surface. They help correct the cornea's refractive error, irregularities, and surface abnormalities. The idea of contact lenses was first proposed in 1508 by Leonardo da Vinci, who gave birth to the concept of neutralization of the cornea by a new refracting surface. In 1946, contact lenses made of polymethylmethacrylate (PMMA) became popular and came into vogue. Contact lenses are classified based on the anatomical position, the material used, the mode of wear, and the water content of the lenses. Contact lenses can be single-cut or lenticular cut lenses based on the design. Contact lens's action is based on the inherent property of lenses like wettability, refractive index, water content, oxygen permeability, oxygen transmission, light transmission, resistance to heat, and mechanical property like lens flexure. The various indications of contact lenses are optical, therapeutic, preventive, diagnostic, operative, cosmetic, and occupational. There can be conjunctival complications and mechanical trauma because of lenses. The contact lens fitting and solutions for storage form an essential aspect of contact lens care. This activity highlights the role of the interprofessional team in the management of all these crucial aspects of contact lenses in day-to-day clinical practice. Objectives: Describe the indications for contact lens use. Review the complications associated with contact lenses. Summarize the preparations of contact lenses. Explain the clinical significance of contact lenses. Access free multiple choice questions on this topic.

Contact lenses are artificial prosthetic devices worn on the eye's front surface to substitute for the anterior corneal surface. Contact lenses help correct the refractive error and irregularities of the corneal surface.[1] Contact lenses are described with various specifications like overall diameter, optic zone diameter, base curve, central, peripheral, and intermediate curves, edge, power, thickness, and tint. The contact lens can be of varied types. There can be soft, hard, rigid gas permeable contact lenses.[2] The various indications of contact lenses can be optical, therapeutic, preventive, diagnostic, operative, cosmetic, and occupational. The action of contact lenses depends on wettability, water content, oxygen permeability, transmission, light transmission, refractive index, resistance to temperature, dimensions, and flexural stability.[3] Based on material, contact lenses are divided into focons and filcons. An ideal contact lens should be biocompatible, gas permeable, have good optical properties and tolerance, be mouldable, sterile, stable, and have good surface chemistry. Each type of contact lens has various advantages and disadvantages.[4] The complications associated with contact lens use can be conjunctival, corneal, and mechanical. This activity deals with the anatomy and physiology of contact lenses, indication, contraindications, preparation, complication, and clinical significance of contact lenses.[5]

Conjunctival Allergic conjunctivitis Giant papillary conjunctivitis Superior limbic keratoconjunctivitis[5] Corneal Epithelial edema Epithelial defect Epithelial microcysts Abrasions Superficial punctate keratitis 3 and 9 o clock staining Sterile corneal infiltrates Marginal keratitis Toxic keratitis Corneal neovascularization Microbial keratitis (contact lens-induced keratitis- CLIK) - bacterial, acanthamoeba Warpage Endothelial changes[5] Mechanical- Contact Lens Related Physical damage Lens discoloration Lost lens Lens deposits Tight lens syndrome Acute hypoxia Chronic hypoxia[5]

Patients presenting to the clinic for routine ocular examination and diagnosed with a refractive error are the primary candidates for contact lenses. The other main indications in the younger age group are keratoconus and recurrent corneal erosion syndrome. The optometrist, contact lens paramedical experts, cornea and contact lens specialists, and the counselor have a crucial role in patient management. In a patient with contact lens-related complications, the examining cornea specialist plays a vital role in the diagnosis. The nursing staff helps explain the medication required and the need for regular follow-up. The pharmacists help in arranging the required medicines. The patient's visual outcome results from interprofessional communication and coordination among the staff.[54]

The nursing and allied health staff play an essential role in managing patients in the contact lens clinic. The paramedical staff trained in contact lens assessment, prescription, and application also assess the patients and help apply the varied type of contact lenses based on the indication. The nursing staff also assesses the patients on slit lamp after contact lens fit to determine the fitting. The nursing staff and contact lens paramedical experts can also inform the patient regarding the varied contact lens solutions, hygiene, the timing of wear, and how to store the lenses.[55]

The nursing team and contact lens expert help regularly monitor patients prescribed the contact lenses. The patients are evaluated and monitored on every visit for contact lens fit, comfort, any problems associated with contact lens application, hygiene, and the visual outcome related to contact lens use.[55]