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Z Advanced CLS > Final Everything > Flashcards

Final Everything Flashcards

1
Q

Scleral fitting

-lens insertion

A

Non-presverved sol’n

Over-fill the bowl

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2
Q

Scleral fitting

-3 zones

A

Central
Limbal
Edge

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3
Q

Scleral fitting

-brief how to fit

A

HVID 1st

Methods: vault reduction or vault increase

Center, clear entire K, no bearing on limbus, smooth alignment with sclera

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4
Q

Scleral fitting parameters and sag

-base curve radius (BC)

A

Decr in mm = incr sag

Incr in D = incr sag

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5
Q

Scleral fitting parameters and sag

-total diameter (TD)

A 
Incr = incr
Decr = decr
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6
Q

Scleral fitting parameters and sag

-peripheral curve radii or angle (PC)

A

Decr in mm = incr sag

Incr in D = incr sag

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7
Q

Scleral fitting parameters and sag

-limbal curve radii (LC)

A

Decr in mm = incr

Incr in mm = decr

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8
Q

Scleral fitting

-removal

A

Small DMV

Lower 1/3rd

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9
Q

Scleral fitting

-evaluation

A

Out to in

1) overall
- white light = movement, centration, push up/in/rotate
- blue light = zone sizes, tear layer thickness

2) scleral alignment
- white light = vessels for obstruction

3) limbal clearance
- compare LC to CT (“thou shalt not touch the limbus”)

4) central clearance
- white light = compare CT to K

5) over-refraction
- SAM FAP

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10
Q

Scleral fitting

  • fit is based on
  • key
A

Scleral shape

Sag

  • controls vaulting, desired tear layer thickness (100-600 microns)
  • should match eye + desired tear layer reservoir
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11
Q

OrthoK fitting

-myopia control

A

Atropine > soft bifocal > OK > spectacles > GP

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12
Q

OrthoK fitting

-how it works/physiology

A

Epithelial layer changes

  • normal 50 microns
  • incr in periphery, decr in center
  • redistribution “to certain extent”
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13
Q

OrthoK fitting

  • materials
  • fit as __ as possible
  • avg size
A

High Dk, PMMA

Flat

10.6mm, 90-95% HVID

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14
Q

OrthoK fitting

-process

A

Start with best possible lens fit (mid-periph back surf aligned to K (AC))

Treatment zone (center, 6.0-6.5mm) is flattened

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15
Q

OrthoK fitting

  • BC formula
  • most important thing
A

BC = (flat K) + (MRS) - (RR)

Centration = alignment curve (AC) is responsible

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16
Q

CRT (Spors)

  • RZD is available in what increments
  • LZ (landing zone) is available in what increments
A

25 microns

1 degree (15 microns)

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17
Q

CRT (Spors)

-if riding high/flat/loose

A

Need to incr RZD by 25 microns

18
Q

CRT (Spors)

-if thin edge clearance

A

Need to decr LZA by 1 degree

19
Q

CRT (Spors)

-if little/no central touch

A

Need to decr RZD by 25 microns

20
Q

CRT (Spors)

-what do the markings 915533 mean

A

BCR 9.1
RZD 550
LZA 33

21
Q

CRT (Spors)

-what the 3 types of topography map mean

A

Smile = flat

Island = tight

Bull’s eye = ideal

22
Q

CRT (Spors)

-if MRx is -1.00

A

Need to use larger RZD

-e.g. go from 8.6 to 8.8 (flatter to incr myopic correction)

23
Q

CRT (Spors)

-primary reason to change LZA from 33 to 34

A

Decr edge clearance

24
Q

CRT (Spors)

-what is a typical BOZD/OAD combo

A

6.0/10.5 (or 10.6)

25
Q

Nystagmus

-most common cause of opscillopsia

A

Arnold-Chiari

  • downbeat (fast phase down), greater in downgaze (reading)
  • pathognomonic lesions = congenital malformation hindbrain, downward elongation BS/cerebellum into cervical spinal cord area
26
Q

Nystagmus

-other causes

A 
Foramen magnum tumor
MS
Spinocerebellar degen
BS infarction
Posterior fossa malformation
27
Q

Nystagmus

-reduction methods (2 main)

A

SRX with prism

SRX CLS telescope

28
Q

Nystagmus

-how CLS telescope system works

A

System

  • high plus specs = images closer to center of rotation
  • high minus CLS = restores focus to retina

Decr amp and frequency

  • magnification
  • dampen convergence
  • decr rotational mag
  • tactile feedback from the lids
  • weight (?)
29
Q

Nystagmus

-limits of telescope system

A

Optical aberrations

VF

Requries stationary head (no tremors)

30
Q

Keratoconus

-ideal fit

A

Intra-peripheral 3-point touch

  • weight of CLS distributed across K
  • slight apical feather touch, paracentral celarance, mid-periph bearing, periph edge clearance
  • start with flat K BCR
31
Q

Blanchards

-OneFit design with excessive central clearance

A

To decr clearance = incr BC

0.1mm change in BC = 50 micron change in clearance

32
Q

Piggybacks

  • when to use
  • lens types
A 
Last resort (under-utilized)
RGP intolerance (poor fit, sensitivity)

High Dk SiHy = comfort/fit (reduced edge sensation)
-bandage CLS
High Dk RGP = optics/regular spherical refractive surface

High Dk = >100

33
Q

Piggybacks

  • GPLI
  • if pt has low K apex resulting in GP lens positioning low on SCL
  • contribution of lenses
A

Very lower power SiHy under the GP

Use moderate plus SCL (+6.00)
-thicker center lens thickness will help it center

Moderate plus SCL has little-no effect because only 20% of it’s power contributes
-e.g. +6.00 lens = +1.20 power

34
Q

Color vision

-CLS

A

Red for RG deficiency

35
Q

Special eyes arc length calculator

-requires what numbers

A

HVID
Rx
K’s

36
Q

CRT

-sag depth too shallow

A

Incr RZD = incr sag depth

37
Q

CRT

-sag depth too high

A

Decr RZD = decr sag depth

38
Q

CRT

-excessive edge clearance

A

Incr LZA = decr edge clearance

39
Q

CRT

-insufficient edge clearance

A

Decr LZA = incr edge clearance

40
Q

CRT

  • first to improve the fit
  • fine-tuning the fit
A

Change RZD

Change LZA

Z Advanced CLS (1 decks)

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