There is a very fine line here and great care must be taken not to be guilty of professional misconduct whilst genuinely trying to help a patient select the best frame during a dispensing.
Firstly, let’s look at the law. What constitutes a ‘contact lens fitting’? The law strictly governs who may and may not fit contact lenses. In brief only a registered optometrist, a registered CLO or a medical practitioner may fit contact lenses. The law obviously makes allowances for students, both pre-reg optometrists and trainee CLOs, to fit contact lenses under the supervision of a suitably qualified person.
As the DO in question would argue, inserting a contact lens for the sole purpose of aiding a patient’s frame choice cannot constitute a fitting. I would agree except that I feel there should be some safeguards before any contact lens is inserted into an eye. The very safeguards that I believe are necessary, checking corneal integrity on the slit lamp and calculating the best power for the task of frame selection to name just two of them, could be deemed to be ‘fitting’ the contact lens.
Is there a safe, legal way to give patients the undoubted advantage of good vision whilst selecting a frame? I think that any such act must be done under the supervision of the optometrist who conducted the eye examination, and who would have knowledge of the cornea; or a CLO who is on the premises, able to check to their own satisfaction that the patient is not at any risk and calculate the appropriate lens power to aid dispensing. Not to do this may also put the DO concerned at risk. It may well be that the experience is so good as to encourage the patient to continue with a full contact lens fitting.
If we, as a profession, wish to keep the moral high ground that all contact lenses are fitted by properly qualified practitioners we must demonstrate that in every circumstance the wellbeing of the patient is our first concern.