5.1.4 Instructions the patient in rigid contact lens handling and how to wear and care for them Flashcards
Indicators: Instructs the patient in the techniques of RGP lens insertion, removal and other relevant handling instructions. Instructs a patient on the principles of RGP lens wear and care including the use RGP lens care products. Additional guidance This must include: Sufficient detailed knowledge of own lenses and solutions to advise appropriately and safely sufficient general knowledge of materials and care regimes to resolve problems.
Lenses used in practice:
- Generally ML92 maxim (Fluorosilicone acrylate)
- ML92 – lens material, madden and layman?
- Maxim – spherical design, back surface multi-curve (multi-curve because centre is for Rx, more than 1 curve at edge stabilisation)
- Other lenses by Bausch & lomb: quantum (spherical centre with aspheric edge)
Teach : Insertion
Ensure clean hands before handling
Check solutions are in date
Opening pack – ensure the lens has been soaked in solution, check CL for nicks, scratches and chips before insertion
CL positioned index finger dominant hand
Drop some solution into lens bowl to act as a cushion
Px should be looking straight ahead
Non-dominant hand – look down and secure upper lid
Dominant hand middle finger – look up and secure bottom lid
Place contact lens on the upper area of the coloured part of the eye
CL should not be moved on eye, can use lids to manipulate if needed
Teach : Removal
Secure top and bottom lids as above
Px looking straight ahead
Pin top eyelid against the top of the RGP
Tuck bottom lid under the bottom of the RGP
Ensure the lids are parted wider than lens diameter
Bring fingers together in a scissor motion so the lids borrow under the lens and the lens pops out
Rinse and the lens before storing in new solution
MPS
Generally use an all-in-one MPS solution, reduces user error
Multi-action solution
Polyhexanide – disinfectant/preservative
EDTA – chelating agent
Sodium phosphates - buffer
Poloxamer – surfactant, clean lenses
Sodium chloride – tonicity
MPS: Cleaning procedure
Place lenses in case overnight, soak for at least 4 hours before wear – always using fresh solution
Remove lenses from lens case, use 4 drops/20second rub on each side
Rinse with steady stream for 5 seconds
Discard solution from case, and clean with solution – clean tissue to dry case is recommended
Solution can be used for conditioner/cushion effect on insertion
Two step:
More room for user error
Good for px’s who are heavy depositors
Usually order in Boston 2 step
Cleaning procedure
- Rub both sides with 2-4 drops of Boston cleaner on palm of hand 20s
- Rinse each side with saline for at least 5 seconds to remove cleaner
Saline e.g. Bausch and Lomb sensitive eyes
- Place lenses in empty case and fill to top ridges with fresh Boston original conditioning solution
- Soak lenses for at least 4 hours before wear
- Before insertion, can wet lenses with conditioning solution for additionally cushioning
Additional cleaning steps:
- Protein remover enzyme tablets can be done weekly on pxs who are heavy depositors
Lenses should be cleaned and rinsed after treatment
E.g. Boston one step liquid enzymatic cleaner - Hydrogen peroxide cleaning can also be used, or additionally used once weekly for deep clean
