Use of this database indicates the user is an Eye Care/Health Care Professional and has read, understands and accepted all the terms of use as outlined in the Disclaimer.

This Wear & Care is to offer all patients the latest gold standard advice on safe contact lens wear.  It is also excellent record keeping as a copy will be kept with the patient records or scanned electronically so can be kept on a patient database. I would recommend a patient signs an updated copy every year or if patients are refitted with a different modality of contact lenses. Beth can be contacted at email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Wear & Care of my Contact Lenses

  • I am aware wearing contact lenses increases the risks of eye infections & associated complications
  • I am aware of different modes of contact lens wear such as daily disposable, monthly disposable etc 
  • I acknowledge wearing contact lenses is an elective decision by me and there are alternatives, such as glasses
  • I have had the opportunity to ask questions and know that my Eye Care Professional is available for advice and guidance
  • I must not swim or shower in my lenses
  • I must never clean, rinse my case or contact lenses with tap water
  • The importance of regular aftercare & eye test check ups. I understand lenses can not be supplied to me if I have not attended for my most recent recommended check up
  • I understand lenses can tear or be damaged throughout normal wear
  • I understand that daily disposables must be discarded after removal for whatever reason & are not suitable for sleeping in or reuse
  • I am aware of the significantly increased risks associated with sleeping in contact lenses I should not sleep in my lenses unless I am advised that I can
  • I understand the instructions for insertion & removal of my lenses
  • I must have up-to-date spectacles
  • I understand the cleaning regime & the importance of cleaning my contact lenses and I must always use fresh solution to clean my lenses
  • My Solution None / Synergi / All in one light / Refine One step Peroxide /Boston 2     step / Delta 2 step / Optifree Puremoist / Other.........................................................
  • Opened solutions should be discarded after …….......90 Days…………………
  • Pots (if used) should be replaced monthly

The cost of my contact lenses………………………………………………………
New To Lenses Contact Lens Trial Fees...... £   includes 12 months aftercare
Contact Lens Annual Aftercare Appointment Fees…£   or free if pay monthly standing order

In case of any irritation, discomfort, loss of vision or eye redness my lenses must be
removed immediately. If symptoms persist seek medical advice.
During Business Open Hours:
Practice Details
Out of hours;
Phone 111 or go to Accident & Emergency at the nearest hospital
My Maximum wearing schedule ............... Days per week ............... Hours per day
Sleeping in contact lenses Yes / No. Maximum Number of sleeps in a row .........
My lenses must be disposed of after a maximum of 1 use, 2 weeks, 1 month, 1 year
of opening regardless of number of days worn.

My Next appointment…………………………………………………………………
I have received a copy of this information
Name of Patient…………………………………………………………………………
Signature………………………………………………………………..............……Date