CL 2-2: GP Parameters 2014 Flashcards
GP Manufacturing: (1) Polymerization
- It’s a Combination of what 2 THINGS?
- The Final Products are what?
a. What can these then be cut into? - What are these put through at this point?
a. How does this Process work?
- of Monomers and other ADDITIVES (like TINTS)
- RODS
a. Buttons - an ANNEALING PROCESS
a. Heat the material to a VERY HIGH TEMP in an Oven, then cool it VERY SLOWLY; You get a MORE HOMOGENOUS END PRODUCT
GP Manufacturing: (2) Machining
- Lathe-Cutting
a. Which surface is CUT FIRST?
b. Cannot produce EXCESSIVE HEAT: WHY? (what will happen to the CL)?
c. Does Manufacturing of the MATERIAL get more difficult with a HIGHER/LOWER Dk?
2. Base curve is cut with what tool?
a. Base Curve Surface is then what?
- a. CONCAVE first, then Convex
b. It will cause DISTORTION
c. HIGHER Dk = More difficult to manufacture - a LATHE
a. Polished
GP Manufacturing: (3) Blocking
- Lens mounted back on LATHE
a. They then use what?
b. This product has three properties or things it does… - Slide 13: Ask: Are ALL GPs a NON-WETTING LENS???
- a. Use of “PITCH” (WAX)
b. i. Vegetable Tar Product
ii. Low Melting Point
iii. Leaves Residue
GP Manufacturing (4): FRONT CURVE Cutting and Polishing
- Similar to BASE CURVE, except what kind of surface is created?
- The Blank is reduced to its what…? (2)
- Polishing is SIMILAR to what?
- CONVEX
- it’s FINAL THICKNESS and POWER
- to BACK SURFACE
GP Manufacturing (5): Finishing
- Lens is cut down to DESIRED DIAMETER (how much larger though to Allow for Edge Shaping and Polishing?)
- What Curves can now Be Applied?
- Soft Pad is used to do what 2 things?
- What is the FINAL STEP before INSPECTION?
- about 0.1-0.2 mm larger
- Peripheral Curves
- Polish and BLEND PERIPHERAL CURVES
- EDGE POLISHING
GP: Properties
- What are the 3?
- Modulus (Resistance to deformation)
- Specific Gravity (Weight)
- Oxygen Transmissibility
GP: Properties (2): Modulus
- Modulus = ?
- What does the slope of this refer to?
- Stiffness of a Material is the Ability of a GP to do what?
- How do you figure it out for a GP?
- Stress/Strain
- the Stiffness measured in MEGAPASCALS (MPa)
- to MASK CORNEAL ASTIGMATISM (resistance to flexure)
- APPLY FORCE (stress) to a lens until it begins to deform (Strain)
GP: Properties: (3): Specific Gravity
- Weight of a GP lens at a given temperature divided by what?
a. What is LOW?
b. Medium?
c. High?
d. What does this affect?
- by weight of an Equal Volume of Water at the SAME TEMPERATURE
a. Less than or EQUAL to 1.10
b. 1.11 - 1.20
c. more than 1.20
d. LENS position on the eye
GP: Properties (4): Oxygen
- Dk = ?
- Dk/t = ?
- Equivalent Oxygen Percentage (EOP) = ?
- Higher Oxygen Permeability does what?
- Permeability
- Transmissibility
- Measured in vivo
- Makes the Lenses more flexible (Material chemistry is a major contributing factor to flexibility)
GP:
- PMMA = ?
- PMMA + Silicone & Fluorine = ?
- Silicone Acrylate/ Fluorosilicone Acrylate = ?
- Very stiff (High Modulus)
- Less Stiff
- Higher Dk GP materials have a LOWER MODULUS than their Lower Dk Counterparts.
(This is the opposite from SCLs)
GP Wettability
- What is Wettability/Wetting Angle?
- Helps us know how well a CL will wet and Stay wet when placed and worn on the Eye
GP Wettability
- Contact Angle: It’s a quantitative measure of what?
- of the Wetting of a solid by a liquid. It’s found at the angle formed by a liquid at the 3 phase boundary where a liquid, gas, and solid intersect.
GP Wettability
- Sessile Drop
- Classic Sessile Drop
- Dynamic Sessile Drop
- Captive Bubble
- Drop of liquid on lens material. Measure CONTACT POINT b/w Liquid and Solid (OLDEST METHOD)
- Gives us an ADVANCING ANGLE
- Gives us an ADVANCING ANGLE (liquid being added) and a RECEDING ANGLE (liquid being removed)
- Bubble of Air trapped against the surface of the GP to determine Contact angle (MORE Repeatable: Less Dehydration of material) (Very wettable for the SMALLER Angle measured from Lens material to Gas)
GP Wettability
- What 4 Factors Affect the Sessile Drop Test? (TESS)
- Time of Measurement
- Environment
- Size of Drop
- Surface Dehydration
GP Wettability: Wilhelmy Plate
- Static or Dynamic Test?
- Dipping GP material in what?
- Measuring Contact Angle between what?
- Dynamic Test
- in and out of a test solution
- b/w Lens material and Solution
Dynamic Contact Angle (CA)
- Contact Angle (CA) Hysteresis = ?
- Advancing CA - Receding CA
Wetting Angle vs. On-eye Wettability
- Wetting Angle measurements are NEEDED for GP lens Testing and FDA Approval. However, do these tests have a CORRELATION with on-eye Wetting/Comfort?
- NO!
Plasma Treatment
- How is it done?
- What does it remove from Manufacturing?
- Wettable Surface without what?
- So what does it IMPROVE?
- What is the LIMITATION?
- Lenses Placed in a VACUUM chamber and Bombarded w/Plasma Gas
- RESIDUALS from manufacturing
- w/o Extra Cleaning before dispensing
- Improves wettability
- It’s unknown how long the Tx lasts.
Silicone Acrylate (SA)
- What does Adding Silicone do to O2 Permeability?
- What 3 things does SILICONE DECREASE?
- Charge on SA Surface?
a. What does this ATTRACT?
- Increases it
- Decreases Wettability, Stability, and Deposit Resistance
- Negative Ionic Charge
a. Protein Deposits
Fluorosilicone Acrylate (FSA)
- Why would we introduce Fluorine?
- What does Fluorine do to O2 permeability?
- What does FLUORINE DECREASE (3 things)
- Is Fluorine Hydrophobic/Hydrophilic?
a. What does it Resist?
b. What does it Attract?
- Because you can only add so much silicone BEFORE compromising Lens Properties
- Increases it
- Wettability, Stability, and Deposit Resistance (But not as much as silicone)
- Hydrophobic
a. Protein Deposits
b. ATTRACTS LIPIDS!!
Dk Classification
- Low
- High
- Hyper
- Less than or EQUAL to 50
- 51-99
- More than or EQUAL to 100
Choosing a Material
- Low Dk
a. Best for what kind of Astigmatism?
b. DW, FW, EW?
c. What 2 things are OPTIMUM? - High Dk
a. Best for what?
b. DW, FW, EW and for whom? (2)
c. They also include what Design?
- Hyper Dk
a. Best for what?
- a. Myopia
b. DW
c. Wettability and Stability - a. Hyperopia
b. Flexible Wear (Hyperopia), and EW (Myopia)
c. Prism Ballasted Lens designs - a. Hyperopia
but can be done for EW (myopia and hyperopia)
GPs and DK/t
- GPs are LESS Dependent on O2 Transmissibility than what?
- Than SCL. Why….IDK LISTEN to lecture…
Tear Exchange
- GP exchange % of underlying tear layer per blink?
- SCL will promote only what?
- The SCL-Wearing Cornea DEPENDS on what?
- 10-20%
- only MINIMAL, if any, tear exchange
- on the Dk/t for Oxygen
Parameters Specified for GP Rx
- What 5 things are the MINIMUM things you need?
- to design your own lens, what would you need? (5)
- POWER, OAD, BCR, Color, MATERIAL
2. On top of the five things listed above, you would need, OZD, PCR, PCW, CT, and BLEND
- What Properties are measured to 1 decimal place?
- What are Peripheral Curves?
a. how are they listed? - Bicurve Lens
- Tricurve Lens
- Properties Measured to 2 DECIMAL PLACES?
- OAD, OZD
- Fitting portion of the Lens
a. PCR x PCW …Have to Add the Width of all PCs to the OZD and Blend to get the OAD - BCR + Peripheral Curve
- Base Curve (BCR) + Intermediate Curve + Peripheral Curve
- PCR and PCW (1-2 decimal places)
Peripheral Curves
- The Curvature of a CL gets Progressively Steeper/Flatter as we move out from Base Curve to 2ndary Curve to Tertiary Curve to Peripheral Curve….
- FLATTER
Determining Number of Curves
- Standard Spherical GP Lenses are Generally what curve(s)?
a. Why? - If a Cornea has Higher/Lower Eccentricity, MORE CURVES will be needed
a. Ex: Irregular Corneas…?
b. Why is this?
- BICURVE or TRICURVE
a. That’s sufficient for Normal Corneal Eccentricity - HIGHER
a. Like Keratoconus
b. More PCs allow for a more gradual Transition
Blend Width
- Curves are blended together to do what?
- 3 types of blend?
- Heavier the Blend, the Harder it is to what?
**Remember: OAD = ?
- to Smooth transition b/w Them
- Light, Medium, Heavy
- the Harder it is to visualize the distinction b/w curves
**OZD + 2PCW (Don’t forget to add all peripheral Curves)
Peripheral Curves
- Use?
- Found in or outside of OZ?
- Specified: Important for what?
- Can be determined by Lab for what kind of cornea?
- Fitting Only
- Outside Optic Zone
- for Atypical Corneal Eccentricities
- for an AVG Cornea
Empirical vs. Diagnostic Fitting. What’s the difference?
Empirical: Call in order for starting lens based on Calculations using PATIENT PARAMETERS (Ks and Rx)
- Diagnostic: Put on a Diagnostic Lens from Fitting set and go from there!
GP Replacement Schedule?
- 1-2 yrs or prn.
usually for Scratched or Cracked Lenses, or Stubborn Deposits
GP Wearing Schedule
- 2 types
- When new to GPs or SCLs, adaptation wearing schedule?
- DW and EW (any overnight wear)
2. Day 1: 4 hrs then +2 hrs each day.
Colors
- 3 Purposes
- Right eye vs. Left eye color?
- 2 other methods of identification?
- Visibility (aid handling); Enhancing (enhance natural eye color);
- Differentiation (b/w right and left lens): RIGHT = gReen and Left = bLue
- Dot or Drill Dot
Verifying GP CLs
- What 4 things?
- Power, OAD, BCR, CT
Power
- When we refer to power, we refer to which one?
- Most CL labs use what power?
- Back Vertex Power
2. Front Vertex Power
Back Vertex Power
- Measured by placing CL w/which SIDE towards us?
- BVP = ?
- CONVEX SIDE
2. F1/(1- (t/n)*F1) + F2
Front Vertex Power
- Opposite of Back
- CONCAVE side towards me
FVP = F1 + F2/(1-(t/n)*F2)
FVP vs. BVP
- When CT is THIN, is there a difference b/w them?
- What about High Plus Rxs?
- No
2. CT becomes more significant and thus BVP and FVP can differ (establish your lab’s convention)
Types of GPs
- Spherical
- Front Surface Toric
- Back Surface Toric
- Bitoric
- 1 Power
- Spherical Back surface, Toric front surface
- Opposite
- Both front and back surfaces are toric
GP Power Verification Conventions
- Front Surface Toric: How do you write it?
- Back Surface/Bitoric GP: What do you do?
- Sphero-cyl Rx (like Spec Rx)
- Read straight off the lensometer (drum power)
Ex: -3.00/-6.00 (MOST PLUS POWER COMES FIRST!)
Verifying Diameter
- What three things?
- Hand held magnifier, Projection magnifier, or V-gauge (measure to nearest 0.1 mm)
Hand Held Magnifier
- How do you measure it?
- Place Posterior Lens surface on Scale; Look thru eyepiece at a fluorescent light; Center Lens Vertically
* Can also verify OZD: Look for demarcation b/w Optic Zone and Peripheral Curves to the nearest 0.1 mm
Projection Magnifier
- Lens is projected onto what?
- Onto Screen and diameter is read off.
V-Channel Gauge: how does it work
Channel down center gets progressively smaller; Insert lens and let gravity slide lens down
THEN read off AT MIDPOINT of GP!
Diameter
- Average for normal Corneas (Overall diameter)
- Affects what else?
- 9.0 to 9.6 is average (can go MUCH bigger for IRREGULAR Corneas)
- Affects Sagittal Depth: LARGER Lens w/Given BCR will FIT STEEPER than SMALLER LENS in same BCR
Base Curve
- Base Curve Radius (BCR/BC) is what?
a. Sometimes called what? - This is measured to what?!
- Verified in what instrument?
- Radius of Curvature of the POSTERIOR SURFACE OPTIC ZONE
a. the Back Optic Zone Radius (BOZR) - in mm to 2 DECIMAL PLACES (to the nearest 0.01 mm; contrast to SCL??)
- Using a RADIUSCOPE
Toricity of GP Contact Lenses
- How do you provide different Powers 90 degrees apart (Toricity)?
a. If found on FRONT SURFACE?
b. Back Surface toric?
c. Bitoric? - How do you verify GP BC?
a. Spherical
b. Front surface toric
c. Back surface/Bitoric GP
- Curvature of the lens is different in each major meridian
a. 2 curves on front
b. 2 curves on back
c. 2 curves on FRONT and the BACK! - a. 1 BC
b. 1 BC
c. 2 BCs: BC FLAT/ BC STEEP (Ex: -7.67 / 7.37)
How many Base Curves?
- Base Curve refers to what?
- Any lens that has a SPHERICAL SURFACE will only HAVE what?
- Any lens that HAS a TORIC BACK SURFACE will have what?
- the back surface
- 1 BASE CURVE (Spherical GP; Front Surface Toric GP)
- have 2 BASE CURVES 90 degrees APART (Back surface toric GP and Bitoric GP)
Base Curve Radii
- Lenses of Equal Diameter
a. Steep
b. Flat
- a. BC = 8.5 mm
b. BC = 9.5 mm
BCR in mm vs. Diopters
- BCR can be converted to m from D and vice Versa: How?
- (n’ - n)/r
n’ = 1.3375 (standard corneal refractive index)
n = 1 (Air)
Curvature in Diopters
How to convert to Diopters from Meters and from mm?
m: 0.3375/r (in meters)
mm: 337.5/r (in mm)
Verifying BCR
- Radiuscope
- Keratometer
- MOST common and MOST accurate
2. Keratometer must be recalibrated; and Needs Special Attachment
Center Thickness
- Must include what?
a. Measured to NEAREST what?
b. Verified USING what?
- Leading ZERO
a. 0.01 mm
b. using a CT Gauge
Quality Control
- Many Measures in place to check that GPs manufactured match their intended parameters: VERIFY LENSES BEFORE DISPENSING (what 2 things at MINIMUM?)
- POWER and BCR at MINIMUM