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CL_Test2 Flashcards

1
Q

Name good candidates for GP Lens

A
  1. Ks and manifest predict good vision
  2. WTR corneal astigmatism is better
  3. Small to mod pupilsize.
  4. FTW
  5. Critical observers due to improved vision
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2
Q

T/F

OZD is larger in GP lens compared to spherical lens

A

False

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3
Q

Name the two benefits in fitting GP lens diagnostically

A
  1. Higher initial success

2. Fewer re-orders

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4
Q

Name some paramaters for selecting lens diameter on GP lens

A

OAD: avg is 9.20-9.50mm
OZD: avg is 7.80 - 8.40mm
HVID-2.3mm
Consider lid aperture size and/or pupil size

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5
Q

What is the trend in fitting flat and steep corneas with GP lens?

A

Flat, hyperopic corneas = Fit with larger OAD

Steep, myopic corneas = Fit was smaller OAD

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6
Q

Name two practical applications for the use of burton lamp

A

Viewing:

  1. Kids
  2. Obese pts
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7
Q

What is a big disadvantage to the usage of anesthetic when fitting GP lens?

A

It does not allow doctor to observe the freak out factor

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8
Q

Name the three fitting philosophies

A
  1. Lid attachment
  2. Interpalpebral
  3. Modified lid attachment
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9
Q

Describe central clearance or central cooling/

Apical clearance or apical pooling

A

The lens is fit STK

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10
Q

Describe central bearing or central touch;

Apical bearing or apical touch

A

The lens is fit FTK

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11
Q

Describe central alignment

A

Minimal apical clearance MAC.

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12
Q

How do you describe the mid-periphery patterns?

A

Clearance
Bearing(touch)
Alignment

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13
Q

How do you describe peripheral clearance(aka pooling, edge lift)?

A

Minimal/inadequate
Moderate/Medium
High/Excessive

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14
Q

What do you need to consider if your over-refraction is greater than or equal to 4.00D?

A

VERTEX DISTANCE

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15
Q

What is the minimum information needed for RGP ordeirng

A 
OAD
BCR
Power
Material
Color
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16
Q

What is and what does it stand for:

F-S/A

A

Fluoro-Silicone Acrylate
It is a type of material
Categorized in low D/k and high D/k

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17
Q

GO through the summary of Diagnostic Fitting GP - steps:

A
  1. Select lens diameter
  2. Select BCR (initial)
  3. Evaluation
  4. Perform Spherical Over-refraction
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18
Q

Look over BENNETT BASE CURVE RADIUS

A

Spherical to low cyl: FTK
Mod cyl: On K
High Cyl: STK

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19
Q

What are the components in evaluating a lens fit?

A
  1. Fitting philosophy
  2. Lens position
  3. NaFl Pattern
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20
Q

What is the common power of Diangostic lenses

A

-3.00D

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21
Q

What is another term for Peripheral Curve Radius (PCR)

A

Tertiary Curve Radius

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22
Q

What happens if you steepen the BCR

A

You get a positive tear lens and SAM

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23
Q

What does SAM stand for

A

Steeper add Minus

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24
Q

T/F

0.10mm increment change to BCR; change the power by 0.50D

A

True.
THis is an approximation
Use conversion chart or convert mm to D to be exact

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25
Q

In what increments do you modify BCR

A

0.10mm increments

The smallest that can be made is: .05

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26
Q

Manipulating BCR parameters:

Flattening vs Steepeining?

A

Flatter BCR to loosen the fit(Increase in mm, decrease in D)

Steepen BCR to tighten the fit

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27
Q

In what increments do you modify OAD

A

0.50 increments

Smallest change: 0.30 smallest sig change

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28
Q

Which two CLs paramaters operate together

A
  1. OAD

2. OZD

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29
Q

T/F

A larger OAD and/or OZD increases the sag ht?

A

True

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30
Q

How do you maintain the same fitting relationship b/w OZD and BCR

A

Flatten BCR by 0.05 while increased OZD by 0.50

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31
Q

Which two CLs parameters are dependent on pupil size

A
  1. OZD

2. OAD

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32
Q

In what increments do you modify PCR

A

Modify in 1.0 mm increments

0.50 smallest significant change

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33
Q

In what increments do you modify PCW

A

Modify in 0.20 increments

Smallest change: 0.10mm

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34
Q

Talk about Blend

A 
Usually don't specify
Anticipate medium
Remove debris
Loosen fit
Eliminate bearing
Factor in patient comfort
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35
Q

Edge: CN bevel and + lenticular are good for…..

A

High minus Cls that are greater than -5.00D

It makes the thicker edges thinner and more comfy for pt

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36
Q

Edge: (-) lenticular are good for….

A

Low minus, less than 1.50D and plus lenses

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37
Q

T/F

Lenses around plano are shaped like a plus lens

A

True

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38
Q

What is the ideal edge fit?

A

It is smoothly tapered with apex 1/2 to 2/3rds posterior

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39
Q

Name some advantages for fitting GP lens

A 
Quality of vision
Safety-Microbial keratitis is more likely for SCL
Long term comfort
Ease of care
Durability
Profitability
Patient loyalty
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40
Q

What are some disads for GP lens

A

Initial comfort
Intermittent wear
Dust will mess it up

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41
Q

What is the main disadvantage for GP lens

A

Its initial discomfort

This is the biggest factor

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42
Q

How does An increase in oxygen permeability affect wettability?

A

It decreases wettability.

As u go higher in oxygen permeability, lens stability also decreases

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43
Q

T/F

Today, we are not as considered about oxygen permeability and wettability

A

True.

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44
Q

Name the four different types of materials?

A

Polymethyl methacrylate (PMMA)
Cellulose acetate butyrate (CAB)
Silicone/Acrylate (S/A)
Fluoro-Silicone Acrylate (F-S/A)

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45
Q

Downside of polymethyl methacrylate (PMMA)

A

Low oxygen permeability

Wettability was real good tho

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46
Q

Ad and disad of cellulose acetate butyrate (CAB)

A

Increased oxygen perm
Scarates easily
Warpage
Obsolete

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47
Q

Tell me about Polycon II

A 
Silicone-Acrylate
Dk 12
Manufacturer is Paragon
It provides good oxygen permeab compared to predecesors
Has good durability
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48
Q

Tell me about Fluoroperm 30

A

Material: F-S/A
Dk: 30
Manufact: Paragon

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49
Q

What is considered low Dk for F-S/A

A

50 and below

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50
Q

What is so special about Menicon Z

A

Dk = 175

Sometimes referred to as a hyper Dk lens

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51
Q

Name the 5 diff F-S/A

A 
Boston XO
Paragon HDS 100
Optimum Extra
Boston XO2
Menicon Z
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52
Q

What is SynergEyes

A

Hybrid lens
Dk rigid = 130
Dk Soft skirt = 84.
(it gives the rigid lens quality and the soft lens comfort).

53
Q

T/F

Plasma trt is a coating

A

Nope

54
Q

What does plasma trt do to wettability?

A

It enhances initial wettability(decreasing the wetting angle)

55
Q

Are most lens designs tri-curves or tetracurves?

A

Tri-Curves

56
Q

Define Standard geometry

A

Eye is steeper in the center and it flattens as you go out in the periphery.
The opposite occurs in Reverse Geometry.

57
Q

What is the lens called when you get
2 BCR
2 powers
1:1 Ratio (BCR:Power)

A

SPE bitoric lens

58
Q

What is the lens called when you get
2 BCR
2 powers
Ratio is not 1:1 (BCR:Power)

A

Back Surface toric lens if……………..
1:1.5 = PMMA
or
1:1.4 (GP)

59
Q

What is the lens called when you get
2 BCR
2 powers
Ratio is not 1:1 (BCR:Power)

A

CPE Bitoric Lens
Not 1:1.5 = PMMA
or
Not 1:1.4 (GP)

60
Q

T/F

For a tricurve lens, the terms “secondary” and “intermediate” can be used interchangeably

A

True

61
Q

T/F

For a tetracurve lens, the term “secondary” refers to the area immediately outside of the optic zone.

A

True

62
Q

What does projection system measure

A

OAD
OZD
It makes things bigger

63
Q

What does Loupe/V-gauge represent

A

OAD

OZD(loupe)

64
Q

What does center thickness gauge measure

A

Center thickness

65
Q

What does keratometer mounted devices measure

A

BCR

66
Q

What does radiuscope measure

A

BCR

Center thickness

67
Q

When is the diff b/w BVP and FVP significant?

A

With (+) lenses

68
Q

What is Drysdale Principle.

A

BCR - measuring the dist b/w the real img and the aerial img - lens surface and the center of curvature

69
Q

T/F

It is possible to measure SCR and PCR with radiuscope

A

True

But we rarely do this in clinic.

70
Q

A minus tear lens is associated with which fitting relationship?

A

Flat

71
Q

A plus tear lens is associated with which fitting relationship?

A

Steep

72
Q

What does CLIK stand for

A

Contact Lens Identification Kit.

Only good for identifying PMMA & older RGP materials by specific gravity

73
Q

What tool utilizes specific gravity

A

CLIK.

Identified specific rigid lens material by seeing if the lens sank

74
Q

How do you measure surface quality of a lens

A

Slit lamp
Loupe
Projection system

75
Q

Which two blend types are associated with good comfort and good physiological response

A

Medium

Heavy

76
Q

Which blend type is it difficult to identify the junction b/w the OZD and Peripheral curve system?

A

Heavy.

Due to excess polishing.

77
Q

Name the three types of Edge Shape and contour

A

Sharp
Smooth or well-tapered
BLunt

78
Q

Which two edge shapes lead to pt discomfort

A

Sharp

Blunt

79
Q

HOw do you identify Edge shape

A

Slit lamp
Projection System
Palm Test

80
Q

What are the goals of a lens care system

A

Good comfort
Clear vision
Optimum corneal health

81
Q

What are some challenges in creating the ideal lens care system

A
  1. Microbial growth w/o corneal toxicity
  2. Pt non-compliance
  3. Misuse of solns
  4. Pt preservative sensitivity
  5. Lens contamination
82
Q

T/F

SCLs provide fewer opp for lens care products to be absorbed into the lens matrix

A

Falso

83
Q

T/F

Higher wetting angle is good

A

False

84
Q

T/F

SCL soln can be used with GP lenses

A

True

85
Q

How long does it take to adapt to lid sensation?

A

1-3 weeks

86
Q

Which type of GP lens is known to accumulate lipid deposit problems

A

Higher Dk F-S/A

Fluoro-Silicone Acrylate

87
Q

Which type of GP lens is known to accumulate protein deposit problems

A

S/A
Polycon II
Low Dk?

88
Q

How to utilize Walgreen’s Daily cleaner with GPs

A

Used in office as an extra strength lab cleaner.
Not approved for Daily Use - will cause crazing
Contain alcohol

89
Q

Which products contain alcohol?

A

Walgreen’s Daily cleaner
Lobob Optimum
Menicare

90
Q

Which product is similar to Walgreen’s daily cleaner?

A

Miraflow

91
Q

Name the preservative free solns

A
  1. Unisol Saline
  2. Aerosol Saline
  3. Unit dose 0.9% sodium chloride inhalation soln
92
Q

Which product is used off-label

A

Unit dose 0.9% sodium chloride inhalation soln

Not that expensive

93
Q

Is it ok to utilize MPS with scleral lenses?

A

Nope.

Due to stagnant tear reservoir

94
Q

What products can you use for rinsing off GP lenses?

A

MPS

Preservative free saline

95
Q

Which two products do you avoid with Menicon Z?

A

Boston Original

Boston Advance

96
Q

How long do you need to store GP lens in Boston’s conditioning system?

A

4 hours

97
Q

Preservative in Boston Original

A

Chlorihexidine

98
Q

Preservative in BOston Advance

A

Chlorihexidine Biguanide

99
Q

Name the Boston one bottle system?

A

Boston Simplus Multi Action Soln

100
Q

Can you use BOston simplus with Menicon product?

A

Yes.

Bcaz there is not an abrasive cleaner.

101
Q

Name the product with the preservative Subtilisin A

A

Boston One Step Liquid enzymatic Cleaner
It is a drop instead of a tablet.
“we are backing away from enzyme products”

102
Q

Name the preservative in Boston Rewetting drops

A

Chlorihexidine Gluconate

103
Q

T/F

ALcohol is a true preservative

A

False

104
Q

Can the optimum solns be placed directly into the eye?

A

Nope

Needs to be rinsed off

105
Q

How many products can you have to use optimum products

A 
3-4
CDS
Re-wetting Drops
Saline ( need to use twice).
Extra-strength cleaner
106
Q

Which product is similar to the Lobob Optimum product?

A

Menicare

107
Q

Which product smells like bleach?

A

Menicon Progent

Only recommend for ppl who are good at following directions.

108
Q

Do we dispense plungers more with scleral lenses or GP lenses?

A

Scleral

We don’t use plungers for SCL.

109
Q

If a pt had excess lipid buildup on GP lens, what would you recommend?

A

Optimum

Menicare

110
Q

If a pt had excess protein buildup on GP lens, what would you recommend?

A

Boston 2 step

Enzyme cleaner

111
Q

How long do you leave GP lens in Menicon progent vial of mixtures A and B

A

30 mins. If longer; will discolor lens.

112
Q

T/F

A pt can utilize peroxide base systems for GP lens

A

False

Can use for scleral lens.

113
Q

What is the soln for flare?

A 
Increase OZD (AOD)
Improve lens centration
114
Q

What is the soln for 3-9 staining

A

Improve edge design

Improve lens centration

115
Q

What is the soln for low-riding lens

A

IF LA - flatten BCR &/or increase OAD
If IP - steepen BCR
-decreasing overall mass by lenticular design, decreasing thickness, or both

116
Q

Soln for high riding lens

A

If LA-Steepen BCR &/or decrease OAD

117
Q

What is it called when you do not have an edge trt

A

Single cut

118
Q

T/F

A steeper lens is less likely to result in a low-riding lens

A

True
Thus if LA - flatten BCR and/or increase OAD
If IP - steepen BCR

119
Q

What are the solns for Lens Adhesion

A

Flatten BCR
Decrease OZD
Flatten peripheral curve radius.

120
Q

Which way can a WTR cornea decenter the lens?

A

High or low

121
Q

Which way can a ATR cornea decenter the lens

A

Side to side

122
Q

How does crazing result

A

From alcohol based cleaners or solvent

123
Q

What is flexure

A

Lens that r bending on the eye

124
Q

What is warpage

A

Mangled lens that is off of te eye.

125
Q

What is the soln for dry spots

A

Remake lens if due to excessive heat during manufacturing
Improve pt compliance w/ care system
Augment w/ special cleaners like alcohol.

126
Q

Soln for Warpage

A

Handle more gently
Increase thickness
Utilize more stable material
Avoid smooth welled case.

127
Q

Soln for Flexure

A

Increased thickness
Avoid steep BCR and large OZD
Utilize more stable material.

128
Q

Soln for Decentered lens

A

Avoid excessively flat or steep BCR

Toric Lens BCR

129
Q

Which solns should not be utilized immediately prior to lens insertion?

A

Optimum
Menicare
Menicon Progent

CLs (3 decks)

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