Cleaning/Solutions Flashcards

1
Q

What are the 4 methods of cleaning lenses?

A
  1. Heat
  2. Cold
  3. Chemical
  4. Light
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2
Q

What are 2 pros and 3 cons of heat cleaning lenses?

A

Pros

  1. most effective germ killer
  2. Excellent for sensitive eyes as it is not introducing more chemicals

Cons

  1. Contamination from using homemade saline (Acanthamoeba/pseudomonas grows in 2 days)
  2. Deposits become baked on
  3. Reduces the lifespan of the lenses by 25% (causes edges to curl and ill change the lens parameters)
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3
Q

What is the procedure for heat cleaning lenses?

A
  1. Set up clean work station and wash hands
  2. Clean and rinse lens with saline
  3. Place lenses in fresh saline in case
  4. Heat to 70ºC to 80ºC for 10-20 mins
  5. Remove lenses from heating unit and place case with lenses concave side up
  6. Cover with Saline and stand overnight/let them cool
  7. Rinse lenses and then wear as normal
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4
Q

Describe Cold cleaning lenses

A

Using Hydrogen Peroxide to kill germs. This is the most effective germ killer on the market today.

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5
Q

What is true of hydrogen peroxide cleaners?

A

Hydrogen peroxide must be neutralized perior to wearing.

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6
Q

What are the three methods of neutralizing hydrogen peroxide?

A
  1. Solution - not on the market today
  2. Tablet - uses an extra step (ultra care) which is more popular in the US
  3. Platinum Disc - one step in 5-6 hours the lenses are neutralized
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7
Q

What are 3 pros and 4 cons to using a Cold Cleaning method?

A

Pros

  1. One step - Fast and convenient
  2. Most effectje cleaner
  3. Hydrogen peroxide breaks down to ∴ this system is not introducing more chemicals

Cons

  1. Not safe to put directly into eye
  2. Platinum disc has a limited lifespan (not too problematic anymore)
  3. No rinsing agent (if you drop the lens you cannot rinse)
  4. Not good for “on call” or shift workers
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8
Q

What is the procedure for using a cold cleaning method? How long can this process last?

A
  1. Set up a clean work station and wash your hands
  2. Remove lenses from your eye and place them into their appropriate baskets
  3. In the case fill up to the solution line, place the closed baskets inside, tighten lid and DO NOT shake
  4. Set the case down and wait for bubbles to appear
  5. Over the next 6 hours/overnight the hydrogen peroxide will neutralize and the lenses are safe to wear

You can store the neutralized lenses in the case for 7 days before you would have to repeat the process before wearing

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9
Q

Why is it important to never shake the case of lenses when cold cleaning?

A

This can coat the lid with hydrogen peroxide that will never neutralize and can then drip onto the cleaned lenses

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10
Q

What are some examples of Chemical cleaners?

A
  1. Renu, Complete, Biotrue, Optifree Puremoist (for Hydrogel Lenses)
  2. Solocare Aqua, Optifree Puremoist, Renu, Biotrue (for Silicone Hydrogel Lenses)
  3. Boston Simplus (GP lenses)
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11
Q

What are some capabilities of Multipurpose Cleaners?

A
Clean
Disinfect
Neutralize
Rinse (∴ this solution can go right into your eye)
Lubricate
Store
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12
Q

What are some pros and cons to multipurpose cleaners?

A

Pros
- Digital scrub creates the cleanest lens

Cons

  • ***Chemicals are sitting on the eye all day and this can result in CLARE (Contact Lens Acute Red Eye)
  • Causes more vacuoles and microcysts
  • Uses hydrostatic waterforces
  • There is no steady stream of solution used
  • Unequal pressure while cleaning
  • Both sides are not rinsed
  • Not long enough cleaning on both sides
  • Parts of the lens are not cleaned
  • Easy to be lazy and just put lenses into the case without cleaning (“this solution cleans!”)
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13
Q

How can you avoid CLARE when using a multipurpose cleaner?

A

First clean the lens properly using a MPS and then store the lens in saline for 5+ hours

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14
Q

List the steps of the Digital Scrub Method

A
  1. Clean your workstation and wash your hands
  2. Remove the lens and place the lens in your palm concave side up
  3. Put 3-4 drops of solution in the lens
  4. Image a clock face on the lens and go back and forth at each hour of the clock using your forefinger (10 seconds total) - DO NOT rub in a circle
  5. Flip the lens and repeat on the front side
  6. Flip the lens back and rinse with solution
  7. Place the lens in the clean case
  8. Fill the case 2/3 full with NEW solution and close the lid
  9. Ideally wait 5+ hours or overnight to put the lenses back in
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15
Q

List the steps of a No Rub method

A
  1. Clean your workstation and wash your hands
  2. Remove the lens and hold the lens between thumb and forefinger
  3. Rinse the lens with a steady stream of solution for 10 seconds on each side
  4. Place the lens in a clean case concave side up
  5. Cover with new solution and close the lids
  6. Wait 5+ hours or overnight
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16
Q

Why is it important to wait 5+ hours before putting chemically cleaned soft lenses back in?

A

It takes about 5 hours for fusarium, pseudomonas and acanthamoeba to die ∴ by waiting 5+ hours you reduce your risk of a corneal ulcer

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17
Q

List the steps of using Bottom Simplus

A
  1. Remove GP lens
  2. Place the lens in a clean case and cover with new solution
  3. Wait 5+ hours to overnight
  4. Perform a digital scrub for 10 seconds each side
  5. Rinse lenses with saline and wear!
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18
Q

What are 2 pros and 2 cons for Light Cleaning lenses?

A

Pros

  • Lenses are exposed to UV light to remove deposits and germs
  • This method is gentle on the lens material

Cons

  • Needs a power source
  • Inconvenient
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19
Q

List the Steps of Light Cleaning your lenses. What is this system called?

A

Purilens System

  1. Clean work station and wash your hands
  2. Remove lenses and place in the baskets of the system
  3. Fill with distilled water
  4. Turn machine on for 20 minutes
  5. Remove the lens and rinse with saline
  6. Place lenses int a clean case and cover with solution
  7. Wait 5 hours or overnight
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20
Q

What are the two most common types of Surfactant Cleaner?

A

Benzalkonium Chloride and Polysorbate 80

21
Q

Define a Surfactant

A

A daily use surface cleaner (soap or detergent). This is a necessary ingredient for a MPS system

22
Q

What is the function of a surfactant?

A

To act as a detergent to break down surface tension

23
Q

What is a pro and a con of surfactants?

A

Pro - Eliminates lipids, mucous and debris

Con - Does not remove proteins

24
Q

What is an example of a surfactant for soft and GP lenses?

A

Soft - MiraFlow or AO Flow

GP - Boston Advance

25
Q

What is the purpose of an enzyme cleaner?

A

This removes proteins from soft or GP lenses

26
Q

What is the recommended use for an enzyme cleaner?

A

Typically 1/week but can be used more often if necessary

27
Q

What is the procedure for an enzyme cleaner?

A
  1. Clean your work station and wash your hands
  2. Soak your lens in saline of MPS
  3. Add the tablet/powder and shake the case
  4. Let this mixture rest for 20 minutes max (no more of the lens will disintegrate)
  5. Rinse the lens in saline
  6. Store in fresh MPS and they are ready to wear
28
Q

What are the 3 types or enzyme cleaners? What are the pros and cons to each?

A

Plant → Papain
𐄂 Leaves enzyme residue

Animal → Pancreatin
✓ No residue
𐄂 Not as effective

**Bacteria → Substillison A (most common today)
✓ Effective
✓ No residue

29
Q

What is the purpose of “In the Eye” Cleaners? How do they work?

A

Designed to help relieve patient discomfort and to be used in CONJUNCTION to regular cleaning.

They are good for continuous wearers of for people with heavy deposits

30
Q

How do “In the Eye” cleaners work?

A

When you install drops the blinking action reduces the surface tension of the lens which helps flush out debris

31
Q

What is the purpose of Viscosity Builders?

A
  1. Help rewet the lens during wear

2. Promote comfort by acing as a cushion the lens

32
Q

Give 6 examples of Rinsing Agents

A
  1. Saline
  2. Unpreserved Saline
  3. Preserved Saline (safer, but can cause allergic responses)
  4. Sterile Unpreserved Saline
  5. Multipurpose
  6. Water (GPs ONLY)
33
Q

What is a risk of regular use of vasoconstrictors?

A

They can cause subconjunctival hemorrhage

34
Q

What is the purpose of a Buffer?

A

To maintain the pH of solutions (slightly alkaline at 7.2 to 7.6) to keep it compatible with corneal tissue

35
Q

What are 3 examples of Buffers?

A
  1. Boric Acid
  2. Trisodium Phosphate
  3. Kenalkomium Chloride (BAK)
36
Q

What are Viscosity Builders?

A

A thick substance used to make the lens comfier and to act as a cushion

37
Q

What are 2 examples of Viscosity Builders?

A
  1. Providone

2. Polyvinyl Alcohol

38
Q

What are Chelating or Complexing Agents? What is their purpose?

A

Molecules that form multiple bonds to a metal ion which increases the stability of the ion complex.

They bond with metal ions to create a stable water-soluble complex

39
Q

What are 4 examples of Chelating Agents?

A
  1. Providone
  2. Polyethyl glycol
  3. Disodium Edetate (EDTA)
  4. Trisodium Edetate
40
Q

What is the purpose of Preservatives?

A

To protect solutions from contamination after opening OR to dispose of harmful bacteria in solutions/on the lens

41
Q

What are 5 examples of preservatives?

A
  1. ***Polyquad Dymed
  2. PHMD
  3. Potassium Sorbate
  4. Sorbic Acid
  5. Thimerosal
42
Q

What is EDTA? What does it do?

A

Disodium Edetate (EDTA). It controls pseudomonas and discourages calcium build up on the lens

43
Q

What is the purpose of Hydrogen peroxide? What does it NOT do?

A

It bleaches the lens while restoring the optical clarity.

It does NOT remove protein deposits

44
Q

What is the purpose of Sodium Chloride?

A

It makes the solution isotonic so it is compatible with tears

45
Q

What are 3 examples of Antioxidants?

A
  1. Asorbic Acid
  2. Sodium Bisulphate
  3. Sodum Perbonate
46
Q

What are Wetting Agents?

A

A chemical used to improve the gettability of a lens. It allows the tear film to uniformly spread over the lens surface

47
Q

What are 3 examples of Wetting Agents?

A
  1. Polyvinyl Alcohol (PVA)
  2. Poloxamer 407
  3. Polysorbate
48
Q

What are 3 examples of Solvents?

A
  1. Purified Water
  2. Glycerin
  3. Propylene Glycol
49
Q

What are 2 examples of Osmotic Pressure Controlling Salts?

A
  1. Sodium Chloride

2. Potassium Chloride