aftercare_routine_flashcards

Question 1

What should be included in preliminary questioning for contact lens aftercare?

Answer 1

RFV, LAC, LEE, spectacles up to date, vision with and without spectacles, and how long the patient has worn contact lenses.

Question 2

What should be checked regarding current contact lenses during aftercare?

Answer 2

Brand and modality, how old the current pair is, WTT, AWT, MWT, and how many days per week they are worn.

Question 3

What questions are relevant for assessing contact lens wear?

Answer 3

Vision through contact lenses, comfort, any irritation, redness, dryness, and whether the patient swims, sleeps, or showers while wearing lenses.

Question 4

What should be asked about handling technique for monthly contact lenses?

Answer 4

How the lenses are stored, how often the solution is changed, how often the case is cleaned or replaced, and how often the lenses are cleaned or replaced.

Question 5

What are key questions to ask regarding past ocular history (POH)?

Answer 5

Any diagnosed eye conditions, flashes, floaters, diplopia, headaches, eye surgeries, trauma, or history of patching as a child.

Question 6

What family ocular history (FOH) is important to ask about?

Answer 6

Any family history of eye conditions, including glaucoma or AMD.

Question 7

What questions should be asked about general health (PGH)?

Answer 7

Any general health conditions, medications, allergies, high blood pressure (HBP), diabetes (DM), and whether the patient is a smoker.

Question 8

What should you ask regarding family general health (FGH)?

Answer 8

Family history of general health conditions, HBP, or diabetes.

Question 9

What lifestyle factors should be discussed during contact lens aftercare?

Answer 9

Occupation, VDU use, hobbies, and whether the patient is a driver.

Question 10

What steps are involved in over-refraction during contact lens aftercare?

Answer 10

Measure distance VA, over-refract (+1.00 and duochrome), and measure final distance and near VA.

Question 11

What is assessed when evaluating contact lens fit using a slit lamp?

Answer 11

Centration, comfort, coverage, and post-use tear (PUT) with a diffuse filter. Lag and sag are measured using a slit beam.

Question 12

What is the normal range for contact lens lag and sag?

Answer 12

A normal fit measures 0.2-0.6mm for lag and 0.4-0.7mm for sag (measured with a 1mm dot).

Question 13

What should be evaluated during a health assessment using diffuse and indirect retroillumination?

Answer 13

Conjunctival redness, blepharitis, MGD, limbal redness, neovascularization, and tear quality.

Question 14

What is the role of sclerotic scatter in contact lens assessments?

Answer 14

Sclerotic scatter is used to check for corneal infiltrates.

Question 15

How is tear prism height measured, and what are the grading values?

Answer 15

Tear prism height is measured using a beam or 1mm dot. Grades: G1 > 0.3mm, G2 = 0.2mm, G3 < 0.1mm.

Question 16

How does fluorescein aid in contact lens assessment?

Answer 16

It binds to epithelial cells with increased permeability, indicating dead or damaged cells. Cobalt blue light is used for further assessment.

Question 17

What are the TBUT thresholds for contact lens suitability?

Answer 17

> 15 seconds = suitable, 10-15 seconds = suitable, 5-9 seconds = limited suitability, <5 seconds = contraindicated.

Question 18

What changes might be made to contact lenses based on over-refraction and fit?

Answer 18

Adjust the total diameter (TD), base curve, or fit tightness based on issues such as poor centration, corneal exposure, or discomfort.

Question 19

What management advice should be provided during contact lens aftercare?

Answer 19

Recall schedule, health advice, and care instructions including removal of lenses for redness, pain, or vision loss, no swimming or sleeping in lenses, proper cleaning, and timely replacement.

Question 20

How is blepharitis managed in contact lens wearers?

Answer 20

Cease lens wear for severe cases (Grade 3 or 4), use lid hygiene measures like warm compresses and tea tree oil wipes, and consider daily disposables to reduce infection risk.

Question 21

How should MGD be managed in contact lens wearers?

Answer 21

Continue lens wear if tolerated, use artificial tears, and switch to low-water-content lenses to avoid tear film absorption by the lens.

Question 22

What causes bulbar conjunctival staining, and how is it managed?

Answer 22

Caused by mechanical trauma from lens edge, dry eyes, or solution toxicity. Managed with blinking exercises, rewetting lenses, or changing the lens fit or solution.

Question 23

What can cause bulbar conjunctival hyperaemia, and how is it managed?

Answer 23

Causes include solution toxicity, dry eyes, infection, or corneal hypoxia. Manage by refitting with higher Dk/t lenses or using ocular lubricants.

Question 24

How is Lid Parallel Conjunctival Folds (LIPCOF) managed?

Answer 24

Manage >G2 cases with refitting using lower water content lenses and lubricants, or switch from SiHy to Hydrogel lenses to reduce mechanical stress.

Question 25

What is the typical cause and management of Contact Lens Associated Papillary Conjunctivitis (CLPC)?

Answer 25

Caused by solution toxicity or mechanical force. Manage by changing the care system, reducing edge clearance, or switching to lower modulus lenses.

Question 26

What causes limbal hyperaemia and staining, and how should it be managed?

Answer 26

Caused by hypoxia or tight lenses. Manage by ceasing lens wear, refitting with higher Dk/t lenses, or switching to lower modulus lenses.

Question 27

What causes neovascularization in contact lens wearers, and how should it be managed?

Answer 27

Caused by hypoxia and managed by ceasing lens wear for severe cases, increasing Dk/t lenses, or reducing lens wear time.

Question 28

How are superficial punctate epithelial erosions (SPEE) managed in contact lens wearers?

Answer 28

Managed based on severity: G2 – remove lenses for 24 hours, G3 – for 3 days, G4 – for 7 days. Use lubricants and adjust lens fit or solution.

Question 29

How should inferior epithelial arcuate lesions (Smile Staining) be managed?

Answer 29

Remove lenses for 24-72 hours depending on severity, use lubricants, and perform blinking exercises. Switch to lower water content lenses if necessary.

Question 30

What causes superior epithelial arcuate lesions, and how should they be managed?

Answer 30

Caused by mechanical trauma, hypoxia, or dryness. Manage with lens removal (24-72 hours), lubricants, or switch to lower modulus lenses or RGPs.

Question 31

What causes foreign body staining in contact lens wearers, and how should it be managed?

Answer 31

Caused by foreign bodies under the lens or damaged lenses. Manage by lens removal (24-72 hours), address the underlying cause, and ensure proper lens hygiene.

Question 32

What are mucin balls, and how should they be managed?

Answer 32

Mucin balls form due to tear film collapse between the lens and corneal surface. Usually self-resolving, but manage by reducing wear time or switching to a lower modulus lens.

Question 33

What causes epithelial microcysts in contact lens wearers, and how are they managed?

Answer 33

Caused by hypoxia and managed by ceasing lens wear for severe cases, then refitting with higher Dk/t lenses.

Question 34

What causes infiltrative keratitis, and how is it managed?

Answer 34

Caused by hypoxia, tight lenses, or poor hygiene. Managed by ceasing lens wear, loosening lens fit, improving hygiene, and switching to daily disposables.

Question 35

What is a contact lens peripheral ulcer, and how should it be managed?

Answer 35

A localized corneal inflammation due to infection or trauma. Manage by ceasing lens wear, ensuring proper lens hygiene, and refitting the lenses.

Question 36

What is CLARE, and how should it be managed?

Answer 36

Inflammation caused by bacterial endotoxins. Manage by ceasing lens wear, monitor for 24 hours, refitting lenses, and improving hygiene.

Question 37

What causes microbial keratitis, and what is the management protocol?

Answer 37

Caused by infection of a compromised cornea, with risk factors like EW, poor hygiene, or smoking. Manage by ceasing lens wear and referring for emergency treatment.