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contact lenses Flashcards

1
Q

CLAPC causes

A

CL front surface deposits
mechanical irritation

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2
Q

CLAPC signs

A

enlarged papillae
rough “cobblestone” appearance
palpebral redness

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3
Q

CLAPC symptoms

A

itching
fluctuating vision
irritation when CL removed (acts as cushion from papillae)
mucous discharge

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4
Q

CLAPC management

A
  1. More frequent replacement of CLs
  2. revision of rub + rinse if caused by deposits
  3. switch to daily wear / daily lenses
  4. sodium cromoglicate 2% 4x a day for at least 2 weeks
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5
Q

SMILE STAINING CAUSES

A

mechanical/ physical irritation
evaporation - worse with high water/ thin SCLs (hydrogels)

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6
Q

SMILE STAINING SYMPTOMS

A

most asymptomatic
dryness
itchiness
grittiness

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7
Q

SMILE STAINING SIGNS

A

punctuate staining in inferior quadrant
isolated from limbus

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8
Q

SMILE STAINING MANAGEMENT

A

reduce water content
increase lens thickness
switch to silicone hydrogel
ocular lubricants
discontinue lens wear for a few days

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9
Q

WHAT DOES SEAL STAND FOR

A

superior epithelial arcuate lesion

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10
Q

SEAL CAUSE

A

unknown
hypoxia, mechanical issue, decentration

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11
Q

SEAL SYMPTOMS

A

most asymptomatic
dryness
itchiness
grittiness/ burning
CL awareness

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12
Q

SEAL SIGNS

A

epithelial arcuate defect in superior quadrant
inside limbus 10-2 o’clock
usually unilateral
irregular edges
0.5mm wide, 2-5mm long

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13
Q

SEAL MANAGEMENT

A

stop CL wear immediately and review in 1 week (to check full corneal healing)
refit with lower modulus CL (hydrogel)
looser fit CL
ocular lubricants

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14
Q

WHAT IS A CLPU

A

small white circular ulcer (inflammatory) with distinct edges
peripheral

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15
Q

CLPU SYMPTOMS

A

asymptomatic to severe pain
photophobia
watery
FB sensation

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16
Q

CLPU MANAGEMENT

A

cease CL wear immediately until infiltrate resolves (symptoms resolve within 48hrs, infiltrates resolve 2-3wks)

review in 24hrs in case ulcer infective
ocular lubricants
treat underlying blepharitis
can resume CL wear but consider stopping EW

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17
Q

WHAT DOES CLARE STAND FOR?

A

contact lens acute red eye

18
Q

CLARE CAUSE

A

acute inflammatory response usually associated with SCL EW (lack of oxygen overnight) or trapped debris

19
Q

CLARE SYMPTOMS

A

px woken up by painful eye early AM
photophobia
watering
red/irritated eye

20
Q

CLARE MANAGEMENT

A

review next day
temporary discontinuation of CL wear until infiltrates resolve
ocular lubricants
complete resolution 1-3 weeks but can take up to 3/12
restart with DW initially

21
Q

CORNEAL OEDEMA SYMPTOMS

A

asymptomatic unless swelling severe
reduced vision / haziness
haloes around lights

22
Q

CORNEAL OEDEMA SIGNS

A

striae (white vertical lines) —> folds —> diffuse

23
Q

CORNEAL OEDEMA MANAGEMENT

A

maximise Dk/t of SCLs
silicone hydrogel
reduce CL wear

24
Q

NEOVASC CAUSES

A

excessive WT
cornea deprived of oxygen (hypoxia)

25
Q

NEOVASC SYMPTOMS

A

asymptomatic unless severe and growing over pupil

26
Q

NEOVASC MANAGEMENT

A

cease CL wear for 2 weeks
cut WT - no EW, max a few days per week
refit with silicone hydrogel or GP
px education
shorter AC (6/12)

27
Q

STERILE VS INFECTIOUS INFILTRATES

A

sterile - smaller (<1mm), more peripheral, minimal epithelial
damage, no mucous, less pain/photophobia

MK - larger (>1mm), more central, significant epithelial damage, mucopurulent discharge, pain/ photophobia, AC reaction

28
Q

every 0.1 difference in K readings is equal to what?

A

0.5 DC

29
Q

aspheric vs spherical RGP design

A

aspheric - varying curvature across lens surface rather than uniformly spherical shape

30
Q

rule of thumb for rigid lens

A

tear lens power increases by +0.25 for each 0.05mm that BOZR is steeper than corneal radius

increase TD by 1mm, flatten lens by 0.1mm

31
Q

how to correct flat fit RGP

A

steeper BOZR
increase TD to stabilise lens
increase BOZD to give larger sag
thinner lens to reduce mobility

32
Q

how to correct steep fit RGP

A

flatter BOZR
reduce TD to increase lens movement
reduce BOZD to give smaller sag
thicker lens

33
Q

EASYVISION MPS INGREDIENTS

A

polyhexanide 0.0001%
sodium chloride
sodium phosphates
EDTA
poloxamer
water

34
Q

ADVANTAGES AND DISADVANTAGES OF MULTIFOCAL CLS

A

adv - maintain BV, can see in all distances

disadv - compromised vision, visual adaptation, optical performance depends on pupil size

35
Q

ADVANTAGES AND DISADVANTAGES OF MONOVISION

A

adv - good for early presbyopia, easy to fit, less costly for px

disadv - reduced stereopsis + contrast, problems if higher add (above +2D), glare when driving at night, adaptation, limited intermediate vision, unsuitable for monocular px

36
Q

SIMULTANEOUS MFS

A

look through D+N at same time

visual system learns to select appropriate rx depending on object distance (ignore blurred image)

concentric + aspheric design

37
Q

BICONCENTRIC VS ASPHERIC MFS

A

biconcentric = centre D or centre N surrounded by concentric rings of N+D powers

aspheric = D or N in centre with gradual transition to other powers as you move away from the centre

38
Q

SEGMENTED MFS

A

similar to bifocal/ trifocals specs

D power in centre + upper zones
N power in lower portion

39
Q

MONOVISION CLS

A

1 eye corrected for D, other for N

visual system alternates central suppression when alternating between distance and near targets

dominant eye = distance

40
Q

OCULAR DOMINANCE +1D SENSORY TEST

A
  1. full correction in trial frame
  2. px looks at smallest line
  3. introduce +1D in front of RE then LE
  4. which is clearer?
  5. the eye more blurred by +1.00 lens is the dominant eye

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