extended wear CLs Flashcards
what are the 2 types of extended wear ? (new terminology)
planned overnight wear
sporadic overnight wear
name some physiological considerations for extended wear?
- high Dk/t to ensure no significant corneal swelling
- aim for same as normal overnight 4% (Holden & Mertz criteria 87Dk/t OR Harvett & Bonanno 125 Dk/t)
- corneal integrity (no abrasions)
what does the holden & Mertz criteria state the dk/t needs to be to prevent corneal swelling?
87 Dk/t
what does the Harvett & Bonanno criteria state the Dk/t needs to be prevent corneal swelling?
125 Dk/t
name some contraindications for extended wear lenses
- monocular px’s
- previous issues with corneal oedema
- evidence of current neovas
- px prone to CLIPC or other mechanical issues
- diabetics
- evidence of poor compliance
why are diabetics a contraindication for extended wear?
corneas are slower to recover from abrasions therefore will be more at risk of infections and delayed healing
what does the holden & mertz criteria say the Dk/t should be ?
87 dk/t
what does the harvett & bonanno say the dk/t should be?
125 dk/t
indications for extended wear CLs?
- px wants them
- therapeutic
- very young children (aphakes)
- no facilities for disinfection
- vocational requirements
- social acitivities
what is a therapeutic example of extended wear lenses?
entropion - stops lashes causing abrasions
BANDAGE
what is an example of a social activity a px may do where they are unable to disinfect their lenses?
territorial army
what are 3 fitting considerations for extended wear?
adequate tear exchange
what will the fitting be like at the end of the day/overnight
preference for loose fitting
why would you rather an extended wear lens be loose ?
lens will fit slightly tighter at the end of the day
fitting approach for new wearers
- develop successful daily wear first
- have a history of good compliance
- follow similar approach for existing wearer
- consider earlier recalls
fitting approach for existing wearers
- start with daily wear
- examine px after 1st night of sleeping
- review again after a period of time of EW (2-4 weeks)
- revew after at least a weeks worth of wear and towards the end of the day
- aftercare is 6 months maximum
what are the 3 types of complications?
- mechanical issues
- metabolic issues
- infection
fitting approach for an existing wearer
- start daily wear with new lens for 2-3 weeks
- examine px morning after the first night of sleeping in lens
- review again after 2-4 weeks (ideally 1 week and at end of day - to see worst case situation and if fit is still acceptable)
- more regular routine aftercares (6 months) with being more vigilant about signs (e.g. papillae)
are the complications higher in extended wear or daily wear?
of course its extended you idiot xx
