Contact Lenses for Sport Flashcards
1
Q
What are the benefits of wearing CLs for sport?
A
- Wider field of view
o Limitation on edge position of spec lens design
o CL moves with you when move eye – easier to see with CLs & playing sport - Less minification/magnification
o Object size more constant (‘real-world’)
o Depending on sport this may be fundamental e.g. shooting - Less adaptation may be required
o After initial adaptation, changes in CL Rx require v little adaptation (may be quicker in CL than spex) - Greater stability
o Lower risk of dislodgement during wear
o Less chance of CL knocked out than spex off face - Enhanced depth perception
o Allow more stable vision & enhanced depth perception due to less magnification difference between eyes
o Anisometropia can affect depth perception - Fewer aberrations
o Lenses move with eyes (spex – may see rainbows at edge of lens) - Fewer reflections
o Lenses in contact with tears - Not affected by fogging up or rain
o Lenses in contact with tears & not exposed to environmental condition - Less susceptible to dirt
o Spex lenses susceptible to smearing & dirt
o Blink reflex good at keeping it out – glasses may catch dirt instead - Allows protective eyewear or sunglasses to be worn
o Bulk of spec frame often interferes with wearing of protective goggles - Protect against peripheral & obliquely incident UV
o Offer additional protection when used with sun spectacles
o Covers cornea – good for light coming in at side – some UV protection – with sunglasses is best - Low risk of damage to lens during wear (soft lenses)
o High risk of damage to spec lenses during wear (excluding polycarbonate lenses) & potential trauma from lenses & frames - Disposability viable
o Lost or damaged specs are costly to replace - May be better for vision and maybe safer than spex
2
Q
What are the drawback of wearing CLs for sport?
A
- Depending on Rx, vision may not be as good e.g. torics
o For most sports may be an ok compromise – sport dependent - Difficulty with I&R – if only for sport then may not be practicing putting them in much
- Rx ranges
- If it was to fall out or something happen to it
- Hygiene
- Non-tolerance CLs just don’t work for everyone
3
Q
What are the considerations for CLs in sport?
A
- A lot of these pxs may be children
o Entry point to CLs – cant see w/o glasses - Think about communication
- Patience required, make sure px is motivated
o I&R may be tricky
o Not just parent saying they need the CLs - Length of time it takes to play the sport
o Extended wear? What type of CLs? - Environment in which it is played
o Water? High altitude? - General physical demands of sport (extreme body movement, body contact & gravitational forces etc)
o Need info about the sport
o Contact sports – RGPs may be banned in the sport – check the regulations - Need to select appropriate material, wearing schedule etc
- Modify criteria to be sport-specific
- Visual skills must improve or remain consistent, or CLs should be removed or modified (i.e. if no benefit)
o Needs to be as good or better than spex - Be cautious about fitting or refitting an athlete during competitive season
o Changes of CL midseason may affect athlete
o 0.25 change wont make difference but e.g. changing from sphere to toric
o Think about adaptations required for such changes
4
Q
Describe Soft CL as a material for CLs in sport?
A
- SCLs are material of choice – more stable
- Tend to move less compared to RGP lenses less likely to be dislodged
- Dust or debris can get trapped under RGP lens resulting in corneal damage/ decreased comfort
o Think about environment e.g. cyclist – RGP not good idea - For CL dryness or dehydration use:
o Thicker, high water
o Thin, low water
o Or SiHys
5
Q
Describe RGP as a material for CLs in sport?
A
- Excellent VA
- Lens loss more likely
- Avoid with:
o Dynamic sports
o High-risk sports
o Contact sports
Lens can fracture - Large TD
- Would you consider fitting slightly steep?
o To get less movement of lens – consider as option – increase stability
o BUT more liable to get dirt & FBs under it
Fit SLIGHTLY steeper for sport but risk of FBs, could get nipping of conj BVs - Dispense spare pair
o Usually previous pair of RGPs
o Backup pair
6
Q
Describe daily disposable CLs in sport?
A
- Dependent on Rx & availability of lens material
- Potential for lens contamination & handling problems reduced with daily lens
- Allows for single use
- Particularly suited to part-time wear
- Convenient (no solutions, spare lenses readily available, relatively inexpensive for loss etc)
o No cleaning regime to worry about - More expensive in general – good if only playing once or twice a week
7
Q
Describe 2-weekly/monthly CLs in sport?
A
- Dependent on Rx & availability of lens material
- Potential for lens contamination
- Need to think about hygiene
- Cost when lost (more than daily disposable)
- Monthly – better range of Rxs
o Some pxs may wear monthlies day to day & have dailies for sport – good compromise in cost
8
Q
Describe toric CLs in sport?
A
- Spherical CLs for pxs with astigmatism to ~0.75-1.00D
- Toric CLs with astigmatism of 1.00D or above
- Optimum correction vital in many sports
o Spherical equivalent (Sph + ½cyl) may not be suitable for sports
Could try them in spherical equivalent outwith competitive season
o Depends on sport – what vision does px need for their sport? - May be worth fitting toric lenses at lower levels of astigmatism to maximise VA
- May get variability in vison – sensitive to this
o During trial period, get them to try them whilst doing the sport
9
Q
Describe ortho-k lenses in sport?
A
- Individually designed RGP lenses are worn overnight
o Flattens cornea – corrects myopia and some forms of astigmatism - Removed in daytime
- Alteration in corneal curvature reduces myopia & some forms of astigmatism
- May be an option for those athletes unable to tolerate modern CLs/prohibited from wearing them
o Asleep so not able to feel them – not sore when lid closed
o Px may not get on with soft e.g. drying too quickly (depending on sport) - Limited Rx range available -4/-5
- Infection risk similar to other modalities need to clean them
o Sleeping in them - Who are these good for?
o No worries about spex or lenses being knocked off/out
o No need to have spare lenses or solution nearby
o Sports where lenses could be more risky or more likely to be knocked out like boxing or rugby
o Contact sports
10
Q
Describe Acuvue Oasys Transition lenses?
A
- “reduces haloes & starbursts at night”
- “help your vision recover from bright light up to 5 secs faster”
- “squint less, see more”
- All compared to standard Oasys lenses
- NOT a replacement for sunglasses but could be useful when sunglasses cannot be worn
o Periorbital skin and whites of eye not protected – just iris/cornea/pupil
11
Q
Describe DK levels for CLs in sport?
A
- Dk and Dk/t are important
- Low Dk/t = less oxygen to anterior surface
- Duration of sporting activity needs to be taken into consideration to decrease hypoxia
o Most sports a few hr - Low Dk/t lenses may be unsuitable for use at high altitudes due to reduced corneal oxygenation
- SiHys are advisable for skiing and mountaineering
- Older hydrogels not suitable for high altitude
o Think about O2 for these pxs
12
Q
Describe the prescription to correct in CLs for sport?
A
- Maximise VA
- Correct ALL myopic & significant hyperopic refractive errors
- Correct Anisometropia > or equal to 0.50D
- Correct astigmatism >0.50D with toric or RGP lenses – different factors to consider
Sports to consider: squash, rugby (ortho k or soft), water sports, boxing, shooting, hockey, cycling (wrap around glasses can be tricky with aberrations for certain Rxs (wear sunglasses over top of any CLs to protect from dust, wind etc))
13
Q
Describe the risk of infection of CLs in water sports?
A
- Microbial keratitis is significant concern especially Acanthomeba
o Also staphylococcus, pseudomonas so, & other amoebae
o Acanthomeba is not a live bug all time, it hides in cysts, most CL solutions do not work for it - Recommend daily disposable CLs and protective goggles
o Change or clean CLs immediately after event
o Sunglasses may help in some sports (e.g. sailing)
o Px education is crucial – May need to have convo more than once
14
Q
Describe tinted lenses and sport?
A
- There is no hard-and-fast rule as to colour of tint to use for a given sport – depends on person
- Preference specific to individuals and their sports
- Can assess this using Eye Bright Test
- Consists of different coloured lenses incorporating colours to enhance contrast (e.g. yellow) and help light sensitivity/glare (e.g. grey)
- Test conditions should really simulate spotting environment and preferred colour is chosen
- Orion BioSport tinted contact lenses (not available in UK)
- Tinted lenses for visual stress may be useful here
- EyeBright Test:
o Diagnostic for colour preference and light sensitivity - Possible suggestions of sport and lens colour combos:
o Skiing -> brown, red/orange, grey
o Shooting -> reddish brown, orange, yellow
Red/orange used for contrast
o Golf -> grey/green
o Football (& fast-moving ball sports)-> Amber
Helps to see ball
o Cycling -> yellow
o Tennis -> Amber
o Running -> grey/green
o Motor sports -> yellow, red
15
Q
What is important at the aftercare if px is wearing CLs for sport?
A
- Stress necessity of good CL care
o Px may be away for a long time - Improve regimen compliance by using simple care systems
- Emphasise personal hygiene and appropriate lens handling
- Do not compromise on follow-up care
