full_aftercare_routine_flashcards
What are the main components of a preliminary question in aftercare?
RFV, LAC, LEE, spectacles up to date, vision with and without specs, and how long the patient has worn contact lenses.
What should be assessed about the current contact lenses a patient is wearing?
Brand and modality, age of the current pair, WTT, AWT, MWT, and how many days per week the lenses are worn.
What dynamic fit checks should be performed during contact lens fit evaluation?
Centration, comfort, position of the lens in relation to lids, movement on version, and MOB.
What static fit evaluation steps are needed during contact lens fit assessment?
Observer angle (0°), illumination angle (0° or 30°), slit width/height maximum, light cobalt blue, filter Wratten #12, magnification 10-16x.
How can TBUT values determine the suitability of contact lenses?
> 15 secs = CLs suitable, 10-15 secs = suitable, 5-9 secs = limited suitability, <5 secs = contraindicated.
What handling technique questions should be asked during aftercare?
How lenses are put in and taken out, storage, solution change, cleaning/replacement of lenses and cases for monthly lenses.
What questions should be asked regarding past ocular history (POH)?
Any diagnosed eye conditions, flashes, floaters, diplopia, headaches, surgeries, trauma, or patching as a child.
What family ocular history (FOH) questions are important?
Ask about family history of eye conditions, such as glaucoma or AMD.
What should be asked about a patient’s general health (PGH)?
Any general health conditions, medications, allergies, high blood pressure (HBP), diabetes (DM), and smoking status.
What factors should be considered regarding lifestyle in contact lens wearers?
Occupation, visual display unit (VDU) use, hobbies, and driving habits.
What should be included in over-refraction during aftercare?
Distance VA, over-refract (+1.00 and duochrome), final distance and near VA.
How should tear prism height be evaluated in contact lens wearers?
G1 >0.3mm, G2 = 0.2mm, G3 <0.1mm.
What are the key factors to assess during a health check using a slit lamp?
Conjunctival redness, blepharitis, MGD, limbal redness, neovascularization, corneal ulcers, tear quality.
What are common signs of a steep fitting contact lens?
Good centration, minimal movement on blink, stable vision, central pooling, relatively comfortable.
What are common signs of a flat fitting contact lens?
Poor centration, excessive movement on blinking, crosses limbus on excursions, unstable vision, central touch, uncomfortable.
What grading terms are used to evaluate a contact lens fit on the apex?
Apical alignment, apical pooling, apical touch.
What are typical management options for blepharitis in contact lens wearers?
Use warm compresses, tea tree oil wipes, and ocular lubricants. Cease lens wear for severe cases (Grade 3 or 4).
How is MGD managed in contact lens wearers?
Continue lens wear if tolerated, use artificial tears, and consider low-water-content lenses to prevent the lens from absorbing the tear film.
What causes bulbar conjunctival staining, and how is it managed?
Mechanical trauma from lens edge, decentration, tightness, or solution toxicity. Managed with blinking exercises, lubricants, or changing the lens fit.
What causes bulbar conjunctival hyperaemia, and how can it be managed?
Caused by solution toxicity, dry eyes, infection, or corneal hypoxia. Managed by refitting with higher Dk/t lenses or using ocular lubricants.
How is contact lens-associated papillary conjunctivitis (CLPC) managed?
Change care system, reduce edge clearance, or switch to a lower modulus lens.
What causes neovascularization in contact lens wearers, and how should it be managed?
Caused by hypoxia. Managed by ceasing lens wear for severe cases, increasing Dk/t lenses, or reducing lens wear time.
What is the management protocol for superficial punctate epithelial erosions (SPEE)?
Remove lenses for 24-72 hours, use lubricants, and adjust solution or lens material.
What causes inferior epithelial arcuate lesions, and how should they be managed?
Typically caused by rapidly evaporating tear film or incomplete blinking. Managed by removing lenses for 24-72 hours, using lubricants, and switching to lower water content lenses.
What causes superior epithelial arcuate lesions, and how should they be managed?
Mechanical trauma due to high modulus lens or tight lens. Managed by removing lenses for 24-72 hours, switching to lower modulus lenses, or refitting with a flatter lens.
How should foreign body staining in contact lens wearers be managed?
Caused by foreign bodies under the lens or damaged lenses. Managed by removing lenses for 24-72 hours and addressing the underlying cause.
What are mucin balls, and how should they be managed?
Mucin balls form due to tear film collapse between the lens and corneal surface. Management not usually required unless vision is affected.
What causes infiltrative keratitis in contact lens wearers, and how should it be managed?
Caused by hypoxia or tight lenses. Managed by ceasing lens wear, loosening lens fit, improving hygiene, and switching to daily disposables.
What is CLARE, and how should it be managed?
Inflammation due to endotoxins from bacteria accumulating, often caused by sleeping in CLs or tight lenses. Managed by ceasing CL wear, refitting looser lenses, and improving hygiene.
What is microbial keratitis, and what is the management protocol?
Infection of a compromised cornea, managed by ceasing lens wear and referring for emergency treatment. Risk factors include poor hygiene and EW.
How should 3 and 9 o’clock staining in RGP wearers be managed?
Remove lenses for 24-72 hours, reduce lens edge thickness, or refit with a smaller TD lens. Blinking exercises and ocular lubricants also help.
What is dimple veiling, and how should it be managed?
Focal areas of fluorescein pooling caused by air bubbles trapped under the lens. Managed by flattening the lens or changing to a toric back surface lens.
