contact lenses

Question 1

CLAPC causes

Answer 1

CL front surface deposits
mechanical irritation

Question 2

CLAPC signs

Answer 2

enlarged papillae
rough “cobblestone” appearance
palpebral redness

Question 3

CLAPC symptoms

Answer 3

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

Question 4

CLAPC management

Answer 4

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

Question 5

SMILE STAINING CAUSES

Answer 5

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

Question 6

SMILE STAINING SYMPTOMS

Answer 6

most asymptomatic
dryness
itchiness
grittiness

Question 7

SMILE STAINING SIGNS

Answer 7

punctuate staining in inferior quadrant
isolated from limbus

Question 8

SMILE STAINING MANAGEMENT

Answer 8

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

Question 9

WHAT DOES SEAL STAND FOR

Answer 9

superior epithelial arcuate lesion

Question 10

SEAL CAUSE

Answer 10

unknown
hypoxia, mechanical issue, decentration

Question 11

SEAL SYMPTOMS

Answer 11

most asymptomatic
dryness
itchiness
grittiness/ burning
CL awareness

Question 12

SEAL SIGNS

Answer 12

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

Question 13

SEAL MANAGEMENT

Answer 13

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

Question 14

WHAT IS A CLPU

Answer 14

small white circular ulcer (inflammatory) with distinct edges
peripheral

Question 15

CLPU SYMPTOMS

Answer 15

asymptomatic to severe pain
photophobia
watery
FB sensation

Question 16

CLPU MANAGEMENT

Answer 16

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

Question 17

WHAT DOES CLARE STAND FOR?

Answer 17

contact lens acute red eye

Question 18

CLARE CAUSE

Answer 18

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

Question 19

CLARE SYMPTOMS

Answer 19

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

Question 20

CLARE MANAGEMENT

Answer 20

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

Question 21

CORNEAL OEDEMA SYMPTOMS

Answer 21

asymptomatic unless swelling severe
reduced vision / haziness
haloes around lights

Question 22

CORNEAL OEDEMA SIGNS

Answer 22

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

Question 23

CORNEAL OEDEMA MANAGEMENT

Answer 23

maximise Dk/t of SCLs
silicone hydrogel
reduce CL wear

Question 24

NEOVASC CAUSES

Answer 24

excessive WT
cornea deprived of oxygen (hypoxia)

Question 25

NEOVASC SYMPTOMS

Answer 25

asymptomatic unless severe and growing over pupil

Question 26

NEOVASC MANAGEMENT

Answer 26

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)

Question 27

STERILE VS INFECTIOUS INFILTRATES

Answer 27

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

Question 28

every 0.1 difference in K readings is equal to what?

Answer 28

0.5 DC

Question 29

aspheric vs spherical RGP design

Answer 29

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

Question 30

rule of thumb for rigid lens

Answer 30

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

Question 31

how to correct flat fit RGP

Answer 31

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

Question 32

how to correct steep fit RGP

Answer 32

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

Question 33

EASYVISION MPS INGREDIENTS

Answer 33

polyhexanide 0.0001% sodium chloride sodium phosphates EDTA poloxamer water

Question 34

ADVANTAGES AND DISADVANTAGES OF MULTIFOCAL CLS

Answer 34

adv - maintain BV, can see in all distances disadv - compromised vision, visual adaptation, optical performance depends on pupil size

Question 35

ADVANTAGES AND DISADVANTAGES OF MONOVISION

Answer 35

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

Question 36

SIMULTANEOUS MFS

Answer 36

look through D+N at same time visual system learns to select appropriate rx depending on object distance (ignore blurred image) concentric + aspheric design

Question 37

BICONCENTRIC VS ASPHERIC MFS

Answer 37

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

Question 38

SEGMENTED MFS

Answer 38

similar to bifocal/ trifocals specs D power in centre + upper zones N power in lower portion

Question 39

MONOVISION CLS

Answer 39

1 eye corrected for D, other for N visual system alternates central suppression when alternating between distance and near targets dominant eye = distance

Question 40

OCULAR DOMINANCE +1D SENSORY TEST

Answer 40

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