Domain VI: Dispensing & Domain VII: Follow-up Flashcards
Preparing a Soft Contact Lens for Wearing:
Instruct your patients to always wash their hands with a mild soap, rinse completely and
dry their hands with a lint-free towel
true
Preparing a Soft Contact Lens for Wearing:
Instruct patients to avoid soaps containing cold cream, lotion, and oily cosmetics
true
Preparing a Soft Contact Lens for Wearing:
Instruct patients to handle their lenses with their fingertips and avoid using their
fingernails
true fingernails should be kept short and smooth
Instruct patients that prior to opening an individual lens package, shake the lens package
to see if the contact lens is floating in the solution
Have the patient remove or pour the contact lens in the palm of their hand and rinse prior
to inserting the lens in their eye
Prior to insertion, have the patient check the lens for surface defects, nicks, or tears
If the lens is damaged, instruct the patient to use another lens
Remind patients that sometimes lenses maybe damaged or missing from lens package
Patient should be instructed to verify that the contact lens is not inverted or turned inside
out
Taco Test
After Insertion:
a) Have the patient close their eyelids and gently massage the lens into place through the
closed eyelids or
b) Have patient gently manipulate the off-centered lens onto to the cornea, using finger
pressure on the edge of the upper or lower lid
c) Never use fingernails to manipulate the lens in place
yep
a) To remove surface deposits
b) To disinfect microorganisms
c) To improve surface wettability
The Role of Contact Lens Products:
Ph comfort range
6.6-7.8
i) Benzalkonium Chloride (BAK)
ii) Chlorobutanol
iii) Thimerosal
iv) Chlorhexidine
Names of Preservatives:
Additives that cushions lens material
Hydroxypropyl methylcellulose
Additive prevents evaporation
Hydrolock
Demulcents that enhances comfortable contact lens application
Propylene glycol
Polyvinyl Alcohol
wetting agent
Plysorbate
wetting agent
Absorbobase
wetting agent
Viscosity Builders: Found in Artificial Tears to add substance to the tear film and prevent increase evaporation
Methylcellulose
Hydroxethyl Cellulose
Buffers and Osmolarity Control:
Keep the pH of the solution as close to natural tears
Sodium Borate
Sodium Chloride
Sodium Phosphate
Sodium Bicarbonate
Lubricants: Agents that attract moisture and prevent the lens material from drying up when used with
contact lenses in the eye
Hydroxypropyl Methylcellulose
Poloxamine
Artificial Tears -solution to supplement the loss of tear formation
a) Phenyleprine HCL
b) Napazoline HCL
c) Epenephrine HCL
d) Tetrahydrozoline HCL
Decongestants
Replace storage cases every … months
three and Air dry
requires rubbing, rinsing and soaking to achieve disinfection
Multi-purpose solution (MPS)
must achieve a higher kill rate of bacteria and fungi during the labeled soak time
without rubbing or rinsing
Multi-purpose-disinfecting solution (MPDS)
Most MPS systems also contain ingredients that may help improve comfort by …
decreasing dryness
All MPS solutions are approved for NO RUB however, the traditional rub and rinse is
still highly recommended
true
advantages and disadvantages to mps
Simplicity and reduced cost, used with any lens
Higher risk of patient hypersensitivity
Most peroxide systems require a minimum of 6 hours and some may require 10 minutes depending on manufacturer
true
i) better durability
ii) less protein deposition
iii) increased end-of-day comfort.
Silicone hydrogel lenses advantages
82% of practitioners are selecting Silicone Hydrogel materials for new
spherical contact lens patients
i) increased lipid deposits
ii) stiffness of the material
silicone hydrogel lenses disadvantages
Silicone Hydrogel Lenses Group I
< 50% water, non-ionic
Silicone Hydrogel Lenses Group III
< 50% water, ionic
a) Thimerosal Sensitivity
b) Clinical Signs- Vessel Engorgement, Itching
Contact Lens Induced Superior Limbal Keratoconjunctivitis (SLK)
a) Rare painful and potentially blinding infection to the cornea
b) Found in all environments: soil, fresh water, swimming pools, hot tubs, tap water and
even bottled water
c) Use of tap water during lens care (to rinse lenses or the storage case)
d) Wearing contact lenses without goggles
e) Use of Ineffective lens care solutions
Acanthamoeba:
Clearer soaps
are better since they contain less lanolin which can smear the contact lens surface. Avoid
liquid soaps which often contain moisturizers that coat lenses. Dry your hands with a lintfree
cloth to reduce the chance of trapped dust under the lens.
RGP insertion
A suction holder is the most recommended method for lens removal. Make sure that it is
applied directly to the lens and not onto the eye. When the ‘sucker’ has suctioned onto the
lens gently twist the lens off your eye.
RGP removal
a low concentration antimicrobial agent used as a disinfectant in some multipurpose solutions
Polyquad
The FDA tests solutions for the effective microorganism kill ratio for ____ major groups of eye pathogens
4
Corneal exposure to 3% hydrogen peroxide causes
punctate epithelial staining
