This program outline is valid until
Consent
You are being fit with soft, dual focused contact lenses. These custom designed soft lenses shift the image received by the eye so that the image falls on the retina and reduces any peripheral blur, thus slowing the rate of progression. The lenses must be worn on a daily basis to receive the full benefit.
Dual focused soft lenses carry the same risks as other types of contact lenses, such as swelling of the cornea, scratching of the eye, irritation, infection, unusual eye discharge, excessive tearing, dry eyes, sensitivity to light, pain, redness, and distorted vision. These risks are usually temporary if the contact lenses are removed promptly and if appropriate professional care is received. In some instances, permanent corneal scarring, infection or blood vessel growth on the cornea may occur, which can lead to reduced sight in rare cases. Although uncommon, infection of the cornea can develop rapidly and lead to loss of vision. The risk of infection of the cornea has been shown to be greater among patients who wear their lenses overnight than among those who do not sleep in their lenses.
I have read and fully understand the above information. I agree to adhere to the wearing and follow-up schedules as prescribed. If I fail to return for my scheduled follow-up visits, I may forfeit my chance to continue wear of dual focused soft contact lenses. All of my questions concerning my eyes and contact lenses have been answered to my satisfaction.