Patients who have significant contraindications to CL wear should not be fitted. Do not be afraid to tell the patient that you will not fit them. It is better to not fit a patient than to have them develop serious problems later which can negatively affect your reputation and practice.
The patient is paying you to make this judgment
and will normally heed your advice. Even if
the patient will go somewhere else for lenses
you still should not fit them if you feel
strongly they should not be fitted. Use the test:
Would I fit my loved ones (spouse, parent, children)
with contact lenses if they had the same condition?.
Some problems you discover may not be safety problems but just indicate the patient may have some difficulties-such as seasonal allergies, slightly decreased acuity, etc. In such cases fully explain the situation to the patient.
