Informed consent for extended-wear patients.

Because of the risk of complication posed by extended-wear lenses, contact lens practitioners must comply with the requirements of informed consent, which obligate the optometrist to communicate these risks to patients. Documentation of informed consent can be obtained by using printed agreements that describe the risks of wear, instructions for lens care, wearing schedules, and required follow-up evaluations. In determining wearing schedules for patients, optometrists should not recommend more than 7 days (ie, 6 nights) of continuous wear without demonstrable benefit to the patient, and informed consent requirements should be complied with and adequate documentation retained whenever extended periods of wear are contemplated. For wearers of disposable lenses, informed consent is necessary because practitioners are not able to inspect lenses prior to wear. Patients must be advised to remove lenses if pain, redness, reduced acuity, discharge, or photophobia result and to return for examination when these symptoms occur. Documentation of this warning and of other aspects of disposable lens wear may be provided by a printed agreement.