full_aftercare_routine_flashcards

Question 1

What are the main components of a preliminary question in aftercare?

Answer 1

RFV, LAC, LEE, spectacles up to date, vision with and without specs, and how long the patient has worn contact lenses.

Question 2

What should be assessed about the current contact lenses a patient is wearing?

Answer 2

Brand and modality, age of the current pair, WTT, AWT, MWT, and how many days per week the lenses are worn.

Question 3

What dynamic fit checks should be performed during contact lens fit evaluation?

Answer 3

Centration, comfort, position of the lens in relation to lids, movement on version, and MOB.

Question 4

What static fit evaluation steps are needed during contact lens fit assessment?

Answer 4

Observer angle (0°), illumination angle (0° or 30°), slit width/height maximum, light cobalt blue, filter Wratten #12, magnification 10-16x.

Question 5

How can TBUT values determine the suitability of contact lenses?

Answer 5

> 15 secs = CLs suitable, 10-15 secs = suitable, 5-9 secs = limited suitability, <5 secs = contraindicated.

Question 6

What handling technique questions should be asked during aftercare?

Answer 6

How lenses are put in and taken out, storage, solution change, cleaning/replacement of lenses and cases for monthly lenses.

Question 7

What questions should be asked regarding past ocular history (POH)?

Answer 7

Any diagnosed eye conditions, flashes, floaters, diplopia, headaches, surgeries, trauma, or patching as a child.

Question 8

What family ocular history (FOH) questions are important?

Answer 8

Ask about family history of eye conditions, such as glaucoma or AMD.

Question 9

What should be asked about a patient’s general health (PGH)?

Answer 9

Any general health conditions, medications, allergies, high blood pressure (HBP), diabetes (DM), and smoking status.

Question 10

What factors should be considered regarding lifestyle in contact lens wearers?

Answer 10

Occupation, visual display unit (VDU) use, hobbies, and driving habits.

Question 11

What should be included in over-refraction during aftercare?

Answer 11

Distance VA, over-refract (+1.00 and duochrome), final distance and near VA.

Question 12

How should tear prism height be evaluated in contact lens wearers?

Answer 12

G1 >0.3mm, G2 = 0.2mm, G3 <0.1mm.

Question 13

What are the key factors to assess during a health check using a slit lamp?

Answer 13

Conjunctival redness, blepharitis, MGD, limbal redness, neovascularization, corneal ulcers, tear quality.

Question 14

What are common signs of a steep fitting contact lens?

Answer 14

Good centration, minimal movement on blink, stable vision, central pooling, relatively comfortable.

Question 15

What are common signs of a flat fitting contact lens?

Answer 15

Poor centration, excessive movement on blinking, crosses limbus on excursions, unstable vision, central touch, uncomfortable.

Question 16

What grading terms are used to evaluate a contact lens fit on the apex?

Answer 16

Apical alignment, apical pooling, apical touch.

Question 17

What are typical management options for blepharitis in contact lens wearers?

Answer 17

Use warm compresses, tea tree oil wipes, and ocular lubricants. Cease lens wear for severe cases (Grade 3 or 4).

Question 18

How is MGD managed in contact lens wearers?

Answer 18

Continue lens wear if tolerated, use artificial tears, and consider low-water-content lenses to prevent the lens from absorbing the tear film.

Question 19

What causes bulbar conjunctival staining, and how is it managed?

Answer 19

Mechanical trauma from lens edge, decentration, tightness, or solution toxicity. Managed with blinking exercises, lubricants, or changing the lens fit.

Question 20

What causes bulbar conjunctival hyperaemia, and how can it be managed?

Answer 20

Caused by solution toxicity, dry eyes, infection, or corneal hypoxia. Managed by refitting with higher Dk/t lenses or using ocular lubricants.

Question 21

How is contact lens-associated papillary conjunctivitis (CLPC) managed?

Answer 21

Change care system, reduce edge clearance, or switch to a lower modulus lens.

Question 22

What causes neovascularization in contact lens wearers, and how should it be managed?

Answer 22

Caused by hypoxia. Managed by ceasing lens wear for severe cases, increasing Dk/t lenses, or reducing lens wear time.

Question 23

What is the management protocol for superficial punctate epithelial erosions (SPEE)?

Answer 23

Remove lenses for 24-72 hours, use lubricants, and adjust solution or lens material.

Question 24

What causes inferior epithelial arcuate lesions, and how should they be managed?

Answer 24

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.

Question 25

What causes superior epithelial arcuate lesions, and how should they be managed?

Answer 25

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.

Question 26

How should foreign body staining in contact lens wearers be managed?

Answer 26

Caused by foreign bodies under the lens or damaged lenses. Managed by removing lenses for 24-72 hours and addressing the underlying cause.

Question 27

What are mucin balls, and how should they be managed?

Answer 27

Mucin balls form due to tear film collapse between the lens and corneal surface. Management not usually required unless vision is affected.

Question 28

What causes infiltrative keratitis in contact lens wearers, and how should it be managed?

Answer 28

Caused by hypoxia or tight lenses. Managed by ceasing lens wear, loosening lens fit, improving hygiene, and switching to daily disposables.

Question 29

What is CLARE, and how should it be managed?

Answer 29

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.

Question 30

What is microbial keratitis, and what is the management protocol?

Answer 30

Infection of a compromised cornea, managed by ceasing lens wear and referring for emergency treatment. Risk factors include poor hygiene and EW.

Question 31

How should 3 and 9 o’clock staining in RGP wearers be managed?

Answer 31

Remove lenses for 24-72 hours, reduce lens edge thickness, or refit with a smaller TD lens. Blinking exercises and ocular lubricants also help.

Question 32

What is dimple veiling, and how should it be managed?

Answer 32

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.