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Contact lens (CL) complications account for 2.2-10.0% of patients attending ophthalmic Accident and Emergency (A&E) units. A survey was conducted to evaluate disease severity among CL wearers attending the Oxford Eye Hospital A&E Unit. CL wearers without a medical indication for CL wear completed a short questionnaire eliciting CL type and wear schedule. Subsequently, A&E Senior House Officers indicated the diagnosis and whether, in their opinion, the patient could have been managed by their optometrist or contact lens practitioner. Approximately halt ot the CL wearers (321/653, 49%) presented with CL related disorders, but only 16% (53/321) of these had potentially sight-threatening disease. More than a third of these patients were deemed to be inappropriately attending (125/321, 39%). presenting with minor problems such as corneal abrasions, CL handling difficulties and CL solution 'accidents'. Better patient instruction, together with encouragement to consult their optometrist or contact lens practitioner first if problems occur, would greatly reduce the burden of A&E attendance by CL wearers with minor complaints. [ABSTRACT FROM AUTHOR]

The article provides information on how to use the presbyopic contact lens safely. The author advises the opticians to explain the lens wearer regarding the predictable problems, which includes the initial reduction in comfort caused by the lenses usually being larger or thicker, and how to position the head and the eyes to make the most effective use of the lenses. The author also advises to avoid bifocals for first-time contact lens wearers and ensure that the patient is markedly presbyopic.