EST: preliminary considerations and examinations Flashcards
What are the 10 things to discuss with PX in preliminary section?
- Assess suitability
- Understand Expectations
- Reasons for CL wear
- General/Ocular health
- Prev CL history
- Lifestyle
- Occupational and environmental factors
- Outline of fitting procedure
- What is required in aftercare, hygiene and lens care
- Fees
What are the 3 indications and 4 contraindications for CL in terms of vision
Indications:
- Anisometropia
- High rx
- Failures with refractive surgery
Contraindications:
- Low rx
- VA with lenses worse than spex
- Irregular astigmatism
- Prism required horizontally or >3 prism Dioptres vertically
What are the 2 indication and 1 contraindication for CL in terms of occupation
Indication:
- Stage performers
- Flight attendants
Contra:
Where legal constraints apply e.g pilots, fire brigade, Chem lab tech
What are the 2 indications and 1 contraindications for CL in terms of cosmetics
Indications:
- To avoid specs
- To change eye colour
Contra:
1. Active infection/ pathology
What are the 1 indications and 5 contraindications for CL in terms of medical/dryness
Indication:
Bandage
Contra:
- Chronic allergies and antihistamine use
- Systemic diseases with complicate CL wear
- Autoimmune diseases/immunocompromised
- Poor tear quality and quantity
- Giant papillary conjunctivitis
What are the 1 indications and 3 contraindications for CL in terms of psychological
Indications:
Cannot accept wearing specs
Contra:
- Cannot accept idea of lens on eye
- Cannot tolerate any level of discomfort
- Total perfectionist
What are the 3 indications and 3 contraindications for CL in terms of others
Indications:
- Sports
- Hobbies
- Occupation
Contra:
- Poor hygiene
- Lack of motivation (may lead to non-compliance)
- Dry, dusty environments
What are 6 advantages of hydrogel lenses ?
- Excellent initial comfort
- Minimal adaptation time
- Occasional wear is ok
- Disposable
- Low incidence of Edema, lacrimation, flare and photophobia
- Long wearing time is ok
What are 6 disadvantages of hydrogel CLs
- Reduced VA with incorrect astig
- Deposit prone
- Oxygen transmission lesser compared to SiHy (lower dk)
- Less hydration
- Increased risk of bacterial contamination
- Corneal vascularisation with thicker or lower water content lenses
What are 4 advantages of SiHy?
- Excellent O2 permeability
- Very Low risk of vascularisation
- Suitable for extended wear
- Less hydration because of lower water content
What are 3 disadvantages of SiHy?
- Greater incidence of arcuate staining
- More liable to lipid deposits, tend to attract preservatives
- More expensive
What are the 4 advantages of RGP?
- Correction if astigmatism
- Low risk of CL complication
- Suitable for extended wear
- Less hydration
What are 3 disadvantages of RGP
- Require adaptation
- Easier to dislodge from cornea
- Complaint of transient flare
List 4 indications and 3 contraindications for RGP
Indication:
- High astig/irregular cornea
- OrthoK
- Dry eyes
- Unsuccessful SCL wearer (Vision or complications)
Contra:
Contact sports
Dusty
Occasional lens wear
what are 7 decisions for trial fit we have to make for final evaluation?
Decisions is made on specific lens type to trial fi:
- Lens type: RGP / SCL / Toric SCL / Cosmetic lenses etc…
- Modality (Daily / Monthly / Biweekly / Conventional)
- Wearing time
- Lens cleaning regimen
- Brand of lens
- Budget
- Material of lens