CLM - Preliminary Examination, Insertion, and Removal - Week 2 Flashcards

1
Q

Does having contact lenses exclude the need for spectacles?

A

No

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2
Q

List 5 personal indications for contact lens wear.

A

Cosmetic reasons
Highly motivated patient
Sport
Occupation
Large refractive error

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3
Q

List 8 personal contraindications for contact lens wear

A

Environment
Occupation
Low refractive error
Monocular wear
Poor hygiene
Poor manual dexterity
Sensitive eyes (fear of touching eyes)
Poor motivation

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4
Q

List 7 ocular indications for contact lens wear.

A

High refractive error
Anisometropia
Aphakia
Trichiasis
Dry eye syndrome
Exposure keratitis
Nystagmus (children)

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5
Q

List 7 ocular contraindications for contact lens wear. (“these are actually indications” - Bang)

A

Recurrent erosions
Bulbous keratopathy
Ocular dysfigurement
Unsuccessful refractive surgery
Post-keratoplasty
Keratoconus
Children (self esteem)

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6
Q

List 11 cases where additional care would be required for contact lens wear.

A

Cosmetically noticeable strabismus
Conjunctivitis
Dry eye
Glaucoma
Kistory of keratitis
Ocular allergies/hayfever
Decreased corneal sensitivity
Pingueculae
Lid conditions (chalazions/hordeolum)
Pterygia
Uveitis

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7
Q

How can general health affect contact lens wear?

A

Poor health can lead to poor tolerance

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8
Q

How can smoking affect contact lens wear (2)?

A

Dry eye
Particulate matter

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9
Q

How can chronic sinusitis affect contact lens wear (2)?

A

Increased mucus in tears
More lens deposits

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10
Q

How can allergies affect contact lens wear (2)?

A

Increased risk of poor tolerance
Hypersensitivity to solutions/contact lens material

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11
Q

List two skin problems that can be exacerbated with contact lens wear?

A

Acne rosacea and atopic eczema

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12
Q

How can thyroid disease affect contact lens wear (4)?

A

Dry eye
Exophthalmos
Reduced blinking
Less tear flow

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13
Q

How can pregnancy affect contact lens wear (2)?

A

Less stable tear film, increasing chance of intolerance

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14
Q

List 6 issues associated with contact lens wear and diabetes.

A

Blepharitis
Dry eye
Epithelial fragility and reduced healing rate
Higher risk of pathogenic keratitis
Unstable refraction
Reduced corneal sensitivity

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15
Q

True or false
Diabetic patients are generally able to be fit with extended wear contact lenses (sleeping lenses).

A

False

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16
Q

List the 5 components of a preminary workup for contact lenses.

A

Complete history
Refraction
External eye examination
Slit lamp biomicroscopy
Keratomotry / topography

17
Q

List the 6 components of history taking for contact lens wear.

A

Motivation
Ocular history
Occupation
Systemic/allergic history
Medications
Intended wearing type

18
Q

What 5 external eye examination ocular parameters are measured?

A

Corneal diameter (HVID)
Pupil diameter (dim)
Palpebral aperture
Lids tight/flaccid - high/low
Corneal sensitivity

19
Q

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?

A

Thorough anterior eye examination
Lid eversion
Fluorescein staining
TBUT
Effron scale is ideal (otherwise mild, moderate, severe)
Must be done after contact lens fitting

20
Q

What do keratometry and topography provide an initial estimate of?

A

An appropriate contact lens base curve

21
Q

What can forcible compression of eyelids cause? Is this common or rare?

A

Oculocardiac reflex - triad of bradycardia, nausea, and faintness/unconsciousness
Very rare

22
Q

What can be done if a foreign body sensation is felt upon wearing a contact lens? Which type can this be done on?

A

Soft lenses only
Do a scleral swish