Mastery Contact Lens Specialist course
STAFF NAME
STAFF ID
BRANCH
TRAINER NAME
Date
EYE HEALTH CHECK (Contact Lens)
0
/
0
(
0.00
%)
1. Measurement of ocular dimension
0
/ 3 (
0.00
%)
K-reading
Pass
Fail
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Base curve
Pass
Fail
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Prescription
Pass
Fail
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2. Preparing the machine before operation
0
/ 2 (
0.00
%)
Adjust the prescription and set up machine
Pass
Fail
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Adjust customer's position
Pass
Fail
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3. Hygiene
0
/ 3 (
0.00
%)
Using alcohol spray before touching customer
Pass
Fail
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Using groves
Pass
Fail
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Nails
Pass
Fail
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EYE HEALTH CHECK (RIGHT)
0
/
0
(
0.00
%)
Lids & Lashes
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
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Bulbar Conjunctiva
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
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Palpebral Conjunctiva
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
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Limbus
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
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Iris
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
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Cornea
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
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Tears
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
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Crystalline Lens
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
Upload Image
EYE HEALTH CHECK (LEFT)
0
/
0
(
0.00
%)
Lids & Lashes
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
Upload Image
Bulbar Conjunctiva
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
Upload Image
Palpebral Conjunctiva
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
Upload Image
Limbus
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
Upload Image
Iris
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
Upload Image
Cornea
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
Upload Image
Tears
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
Upload Image
Crystalline Lens
Slit Width
Brightness
Magnification
Type of illuminations
Identify
Position of light
Procedure
Fail
Upload Image
Suggestion to Customer
Pass
Fail
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Time Spending
Good
Fair
Poor
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FITTING CHECK (RIGHT)
0
/
0
(
0.00
%)
Comfort
Pass
Fail
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Coverage
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
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Centration
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
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Lag-Sag
0
/ 21 (
0.00
%)
Primary gaze
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
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Up gaze
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
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Lateral gaze
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
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Movement (Push up test)
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
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Visual Acuity (V/A)
Pass
Fail
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Over – Refraction
Pass
Fail
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FITTING CHECK (LEFT)
0
/
0
(
0.00
%)
Comfort
Pass
Fail
Upload Image
Coverage
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
Upload Image
Centration
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
Upload Image
Lag-Sag
0
/ 21 (
0.00
%)
Primary gaze
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
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Up gaze
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
Upload Image
Lateral gaze
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
Upload Image
Movement (Push up test)
Slit Width
Brightness
Magnification
Type of illuminations
Evaluation
Position of light
Procedure
Fail
Upload Image
Visual Acuity (V/A)
Pass
Fail
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Over – Refraction
Pass
Fail
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Suggestion to Customer
Pass
Fail
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Time Spending
Good
Fair
Poor
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Manners while processing on customers
Good (5 - 10 mins)
Fair (10 - 13 mins)
Poor (13 - 18 mins)
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Signatures
Staff Signature:
Clear
Trainer Signature:
Clear