Included  are the parts of a contact lens evaluation (some patients may require additional tests and not all patients require every test every time):

        > 1. Review previous contact lens history;

        > 2. Review current vision, comfort, handling, solutions and any concerns;

        > 3. Distance & near visual acuities with contact lenses;

        > 4. Retinoscopy or Computerized Auto-Refraction over contact lenses;

        > 5. Distance refraction & new distance visual acuities over contact lenses;

        > 6. Near Add determination (including monovision considerations);

        > 7. Biomicroscopy exam with & without contact lenses:

                        a. To observe centering and movement of the contact lens

                        b. To observe the integrity of the cornea & conjunctiva with the contact lens-

                                -Evaluate the formation of new blood vessels
                                    (neovascularization) near the edge of the eye
                                    (limbus) and the contact lens.  These vessels, if left
                                    to grow, can go to the center of the cornea and
                                    destroy vision.

                                -Evaluate the cornea for edema (water retention) which
                                    would indicate that the contact lens is not providing
                                    enough oxygen.

                                -Evaluate whether there are dry spots on the tissue due
                                    to poor wiping by the eye lids.

                        c. Lid eversion to observe the tarsal conjunctiva (underneath
                                    the lid) for possible papules or cysts which can be
                                    due to the contact lens or allergies to the
                                    environment, lens material, or solutions used for
                                    cleaning/storage/wetting.

                        d. Sodium fluorescein dye evaluation: 

                                -Evaluate the tear film quantity and quality

                                -Evaluate the tear/lens inter-relationship

        > 8. Auto-Keratometry (cornea curvature determination);

        > 9. Trial contact lens evaluation:

                        a. Distance and near visual acuities with trial contact lenses

                        b. Retinoscopy over trial contact lenses

                        c. Distance refraction and acuities over trial contact lenses

                        d. Biomicroscopy with trial contact lenses

        > 10. Present Results of Evaluation;

        > 11. Present Recommendations and Treatment Options;

        > 12. Answer Questions;

        > 13. Complete contact lens prescription.