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
