title: Contact lens prescribing in a specialist medical contact lens clinic based in an NHS hospital: an audit of changing practice.
abstract: OBJECTIVE
  To describe the range of indications for contact lenses and the types of lenses being used in an NHS hospital-based specialist medical contact lens clinic and contrast this with information from 12 years ago.
  
  
  METHODS
  A retrospective audit of 596 clinic attendances was performed in the contact lens clinic at the Western Eye Hospital between April 2002 and March 2003. The results were compared with a similar audit performed in 1991. We used the hospitals electronic records, and information on contact lens prescribing was obtained directly from the receipts generated by the contact lens department and the accounts department.
  
  
  RESULTS
  We saw 392 patients with 88.5% of patients requiring 2 or less visits per year. The majority of referrals are for high myopia (28.6%) closely followed by aphakia (25.2%) and keratoconus (24.7%). This is in contrast to 1991 when 68% of referrals were for aphakia and twice as many myopes (17%) were seen as keratoconus patients (8%). A total of 560 lenses were prescribed with 68 different types of lens in use. The seven most commonly used lens types accounted for 61% of all lenses prescribed.
  
  
  CONCLUSIONS
  Medical contact lens clinics provide a specialist service and also provide an important training resource for junior ophthalmologists. Safer cataract surgical techniques have had a significant impact on the case mix seen in our clinic, with the emphasis moving away from aphakic and myopic patients and toward the more challenging to fit eyes with keratoconus or postcorneal surgery.
authors.affiliation: Western Eye Hospital, 171 Marylebone Road, London NW1 9YE, UK. bjlburton@yahoo.co.uk
authors.forename: B J L
authors.initials: BJ
authors.lastname: Burton
authors.forename: A I
authors.initials: AI
authors.lastname: Fernando
authors.forename: T O
authors.initials: TO
authors.lastname: Odufuwa
authors.forename: U
authors.initials: U
authors.lastname: Vogt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003261:Contact Lenses / Q000706:statistics & numerical data*; D003316:Corneal Diseases / Q000628:therapy; D005260:Female; D006782:Hospitals, Special / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data; D055656:Prescriptions / Q000706:statistics & numerical data*; D017755:Prosthesis Fitting; D012030:Refractive Errors / Q000628:therapy; D012189:Retrospective Studies; D006113:United Kingdom