extended wear CLs

Question 1

what are the 2 types of extended wear ? (new terminology)

Answer 1

planned overnight wear
sporadic overnight wear

Question 2

name some physiological considerations for extended wear?

Answer 2

• 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)

Question 3

what does the holden & Mertz criteria state the dk/t needs to be to prevent corneal swelling?

Answer 3

87 Dk/t

Question 4

what does the Harvett & Bonanno criteria state the Dk/t needs to be prevent corneal swelling?

Answer 4

125 Dk/t

Question 5

name some contraindications for extended wear lenses

Answer 5

1. monocular px’s
2. previous issues with corneal oedema
3. evidence of current neovas
4. px prone to CLIPC or other mechanical issues
5. diabetics
6. evidence of poor compliance

Question 6

why are diabetics a contraindication for extended wear?

Answer 6

corneas are slower to recover from abrasions therefore will be more at risk of infections and delayed healing

Question 7

what does the holden & mertz criteria say the Dk/t should be ?

Answer 7

87 dk/t

Question 8

what does the harvett & bonanno say the dk/t should be?

Answer 8

125 dk/t

Question 9

indications for extended wear CLs?

Answer 9

• px wants them
• therapeutic
• very young children (aphakes)
• no facilities for disinfection
• vocational requirements
• social acitivities

Question 10

what is a therapeutic example of extended wear lenses?

Answer 10

entropion - stops lashes causing abrasions
BANDAGE

Question 11

what is an example of a social activity a px may do where they are unable to disinfect their lenses?

Answer 11

territorial army

Question 12

what are 3 fitting considerations for extended wear?

Answer 12

adequate tear exchange
what will the fitting be like at the end of the day/overnight
preference for loose fitting

Question 13

why would you rather an extended wear lens be loose ?

Answer 13

lens will fit slightly tighter at the end of the day

Question 14

fitting approach for new wearers

Answer 14

• develop successful daily wear first
• have a history of good compliance
• follow similar approach for existing wearer
• consider earlier recalls

Question 15

fitting approach for existing wearers

Answer 15

• 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

Question 16

what are the 3 types of complications?

Answer 16

• mechanical issues
• metabolic issues
• infection

Question 17

fitting approach for an existing wearer

Answer 17

• 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)

Question 18

are the complications higher in extended wear or daily wear?

Answer 18

of course its extended you idiot xx