9.12 Contact lens removal: soft lenses

Essential equipment

  • Personal protective equipment
  • Contact lens cleaning solution
  • 0.9% saline solution
  • Low‐linting or lint‐free swabs
  • Non‐sterile powder‐free gloves

Pre‐procedure

ActionRationale

  1. 1.
    Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
    To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [162], C).
  2. 2.
    Wash hands or use an alcohol based handrub and put on personal protective equipment.
    To reduce the risk of cross‐infection (NHS England and NHSI [148], C).

Procedure

  1. 3.
    Wearing non‐sterile gloves and using thumb and forefinger, separate the eyelids. Slide the contact lens onto the conjunctiva (white) of the eye. Gently pinch the lens between the thumb and index finger and lift away from the eye (Action figure 9.11).
    To encourage the lens to fold together, allowing air to enter underneath the lens for easy removal. (Lakhani [104], C).
  2. 4.
    If the lens is a daily disposable, dispose of it immediately in appropriate waste.
    Disposable lenses should not be reused. For the appropriate disposal of waste. To reduce the risk of cross‐infection (Loveday et al [114], R).
  3. 5.
    If the lens is reusable, place the lens in the palm of the hand, apply some drops of cleaning solution to the lens and gently rub the lens with the little finger.
    To clean the lens of debris and contaminants (Lakhani [103], C).
  4. 6.
    Apply 0.9% saline solution to the lens and rinse the lens by rubbing the lens gently between the index finger and thumb.
    To remove residues of cleaning solution and debris loosened during cleaning (Lakhani [103], C).
  5. 7.
    Fill the clean storage case with new lens storage solution. Store the lenses in the contact lens storage case, in appropriate solution as recommended by the manufacturer, and ensure the lenses are placed in the correct storage pots (left and right).
    To prevent deterioration and contamination (Lakhani [103], C).
  6. 8.
    Refer to the manufacturer's instructions for further storage information, particularly if the patient will not be using the lenses for a lengthy period of time.
    To prevent deterioration and growth of organisms. E

Post‐procedure

  1. 9.
    Remove and dispose of personal protective equipment, and decontaminate hands.
    To keep the environment clean and reduce the risk of cross‐infection (NHS England and NHSI [148], C).
  2. 10.
    Document the intervention in the patient's notes.
    To maintain accurate records. To provide a point of reference in the event of any queries. To prevent any duplication of treatment (NMC [162], C; RCN [193], C).
image
Figure 9.11  (a) Moving a soft lens down the interior part of the sclera. (b) Removing a soft lens by pinching it between the pads of the thumb and index finger.
image
Figure 9.11  (a) Moving a soft lens down the interior part of the sclera. (b) Removing a soft lens by pinching it between the pads of the thumb and index finger.