CLM - Preliminary Examination, Insertion, and Removal - Week 2 Flashcards
Does having contact lenses exclude the need for spectacles?
No
List 5 personal indications for contact lens wear.
Cosmetic reasons
Highly motivated patient
Sport
Occupation
Large refractive error
List 8 personal contraindications for contact lens wear
Environment
Occupation
Low refractive error
Monocular wear
Poor hygiene
Poor manual dexterity
Sensitive eyes (fear of touching eyes)
Poor motivation
List 7 ocular indications for contact lens wear.
High refractive error
Anisometropia
Aphakia
Trichiasis
Dry eye syndrome
Exposure keratitis
Nystagmus (children)
List 7 ocular contraindications for contact lens wear. (“these are actually indications” - Bang)
Recurrent erosions
Bulbous keratopathy
Ocular dysfigurement
Unsuccessful refractive surgery
Post-keratoplasty
Keratoconus
Children (self esteem)
List 11 cases where additional care would be required for contact lens wear.
Cosmetically noticeable strabismus
Conjunctivitis
Dry eye
Glaucoma
Kistory of keratitis
Ocular allergies/hayfever
Decreased corneal sensitivity
Pingueculae
Lid conditions (chalazions/hordeolum)
Pterygia
Uveitis
How can general health affect contact lens wear?
Poor health can lead to poor tolerance
How can smoking affect contact lens wear (2)?
Dry eye
Particulate matter
How can chronic sinusitis affect contact lens wear (2)?
Increased mucus in tears
More lens deposits
How can allergies affect contact lens wear (2)?
Increased risk of poor tolerance
Hypersensitivity to solutions/contact lens material
List two skin problems that can be exacerbated with contact lens wear?
Acne rosacea and atopic eczema
How can thyroid disease affect contact lens wear (4)?
Dry eye
Exophthalmos
Reduced blinking
Less tear flow
How can pregnancy affect contact lens wear (2)?
Less stable tear film, increasing chance of intolerance
List 6 issues associated with contact lens wear and diabetes.
Blepharitis
Dry eye
Epithelial fragility and reduced healing rate
Higher risk of pathogenic keratitis
Unstable refraction
Reduced corneal sensitivity
True or false
Diabetic patients are generally able to be fit with extended wear contact lenses (sleeping lenses).
False
List the 5 components of a preminary workup for contact lenses.
Complete history
Refraction
External eye examination
Slit lamp biomicroscopy
Keratomotry / topography
List the 6 components of history taking for contact lens wear.
Motivation
Ocular history
Occupation
Systemic/allergic history
Medications
Intended wearing type
What 5 external eye examination ocular parameters are measured?
Corneal diameter (HVID)
Pupil diameter (dim)
Palpebral aperture
Lids tight/flaccid - high/low
Corneal sensitivity
What four things must be assessed during a slit lamp examination? What grading scale should be used, ideally? Is this done before or after contact lens fitting?
Thorough anterior eye examination
Lid eversion
Fluorescein staining
TBUT
Effron scale is ideal (otherwise mild, moderate, severe)
Must be done after contact lens fitting
What do keratometry and topography provide an initial estimate of?
An appropriate contact lens base curve
What can forcible compression of eyelids cause? Is this common or rare?
Oculocardiac reflex - triad of bradycardia, nausea, and faintness/unconsciousness
Very rare
What can be done if a foreign body sensation is felt upon wearing a contact lens? Which type can this be done on?
Soft lenses only
Do a scleral swish