Ophthalmic instrumentation in contactlens practice

Abstract

Developments in the contact lens field over the past few years have been remarkable, not necessarily because they have represented the sort of ultimate breakthrough which has led to the perfect contact lens that I think is still some way o f f but rather because of the rate of change, not only in terms of design, but also in terms of the development of new materials. The number of materials together with the various design features is, from the point of view of the contact lens practitioner, never mind to the outsider, almost mind boggling. Whilst it perhaps might be argued that the numerous varieties of soft and hard lenses provide the practitioner with a range of options that will enable any patient to be satisfactorily fitted, it could be equally argued and perhaps more effectively so, that the existence of so many variations on a theme is in itself an indication of how far we still are from the combination of features that will eventually give us the ideal set of contact lenses. Why is it that so much development work is going on to find better and better contact lens materials? It is surely not simply related to a desire to find a totally comfortable contact lens but rather related to the need to find a contact lens or series of lenses which do not produce the adverse ocular reactions that have resulted from the use of contact lenses in the past. As practitioners we have an undeniable responsibility to ensure that the patient who is fitted with contact lenses is not put at risk by the use of such lenses. This means that not only must we have the means by which we can ensure that the patient has the correct lenses but also that such patients neither present any contra indications for fitting lenses in the first place nor show any adverse reactions once fitted. Without proper instrumentation such a role cannot be fulfilled. It is not so long since there was a strong school of thought which argued very forcibly that the practitioner with a Burton Lamp did not need a slit lamp. Indeed this view was held within the teaching institutions not so long ago and I can remember being regarded as a crank for always insisting that the slit lamp be used before and after any contact lens examination. Unfortunately many generations of practitioners were brought up on a Burton Lamp diet Society of Medicine, London W.1, in January 1979.