GP Review (JC)

Question 1

In what ways do RGPs offer better quality vision, compared to SCL?

Answer 1

1. Masks corneal surface irregularity
2. Masks corneal toricity
3. Less deposits
4. Increase clarity for treating presbyopia

Question 2

In what ways do RGPs offer better ocular health, compared to SCL?

Answer 2

1. Lower rate of IK
2. Improved dry eye tolerance
3. May stop myopia progression

Question 3

What are the limitations of RGPS (vs. SCL)?

Answer 3

1. Less initial comfort
2. Increased susceptibility to dust/debris
3. Lens loss more likely

Question 4

Vast majority of RGPs are in what modern material?

Answer 4

FSA

Question 5

Name the different surface treatments options

Answer 5

1. Plasma
2. HydraPeg

Question 6

What solutions can be used with HydraPeg?

Answer 6

1. ClearCare
2. Simplus
3. Tangible Clean/Boost

Question 7

High or Low DK better: Hyperopia

Answer 7

High

(Due to lens thickness)

Question 8

High or Low DK better: PKP

Answer 8

High DK

(Important to mitigate risk in high risk patients)

Question 9

High or Low DK better: High Astigmatism (> 2.00 D)

Answer 9

Low DK

(to decrease flexure —> increase stability required for toric fit)

Question 10

High or Low DK better: High Astigmatism (> 2.00 D)

Answer 10

Low DK

(to decrease flexure —> increase stability required for toric fit)

Question 11

High or Low DK better: Dry Eye

Answer 11

Low

(Increase wettability)

Question 12

Fitting Considerations (7)

Answer 12

1. Motivation
2. Sensitivity
3. RE
4. Topo
5. Desired wear schedule
6. Use environment
7. Child w/ corneal scar

Question 13

BC refers to the curvature of ____

Answer 13

Optic Zone

Question 14

Secondary Curve (SC) is also known as the ___

Answer 14

Intermediate Curve

Question 15

In a good fit, what should be avoided?

Answer 15

Apical touch and tight/excessively loose edges

Question 16

In a good fit, where should the CL land? Why?

Answer 16

On mid-peripheral cornea; allows for tear exchange

Question 17

In a good fit, where should the CL be centered? Why?

Answer 17

Over visual axis; to avoid glare

Question 18

Empirical fit is based on ___ (3)

Answer 18

1. MR
2. Topo
3. Lid position/condition

Question 19

For what design is empirical fit a good choice?

Answer 19

Back surface toric

Question 20

What is the first step in basic fitting?

Answer 20

Choose a philosophy

Question 21

A tight eyelid will ____ the lens

Answer 21

Displace

Question 22

A loose eyelid will ___ the lens

Answer 22

Struggle to hold the lens

Question 23

Clinical Pearl
What is a good way to determine whether a pt may not lid attach?

Answer 23

Difficult to flip lids

Question 24

In an interpalpebral lid interaction, what determines the lens position?

Answer 24

Corneal apex

Question 25

In an interpalpebral lid interaction, the lens will be ___ (larger/smaller) and ___ (flatter/steeper).

Answer 25

Smaller and steeper (< 9.2 mm)

Question 26

In a lid attachment, the lens will be ___ (larger/smaller) and ___ (flatter/steeper).

Answer 26

Larger and flatter (> 9.5 mm)

Question 27

Ina lid attachment, what problems are common with the lens?

Answer 27

Dropping

Question 28

Which fit is usually more comfortable: larger/flatter or smaller/steeper?

Answer 28

Smaller & steeper

Question 29

OAD varies from ___ to ___ mm

Answer 29

8 to 11 mm

Question 30

Considerations for choosing an OAD (5)

Answer 30

1. Philosophy 2. Pupil size 3. Centration 4. OZD 5. Corneal size

Question 31

T/F: An anesthetic should be used during first insertion.

Answer 31

TRUE, but pt should be prepared for lens awareness

Question 32

Choosing a Curve (chart)

Answer 32

Question 33

T/F: anesthetic should be used during I/R

Answer 33

FALSE; won’t know if injures eye

Question 34

How long should an RGP settle before assessing with NaFL?

Answer 34

2-3 min

Question 35

Re: Anesthetics No more than __ drops in a 30 min period

Answer 35

3

Question 36

Evaluation of RGP, post-blink: movement should be ___, ___, ___, and of ___ speed.

Answer 36

- 1.5-2 mm - smooth - vertical - medium speed

Question 37

When evaluating lens with lids in normal position, the lens should ___ when the lid move

Answer 37

Remain in Limbal area

Question 38

When evaluating the lens with lids held apart, how should the lens act when pulled to top of cornea?

Answer 38

Drop slowly

Question 39

When evaluating the lens with lids held apart, how would a flat fitting lens act?

Answer 39

Drops quickly and often in a curved path, as it pivots around apex

Question 40

When evaluating the lens with lids held apart, how would a steep fitting lens act?

Answer 40

Falls slow and remains on apex

Question 41

What happens if not enough NaFL is instilled, when evaluating CL?

Answer 41

Falsely appears aligned

Question 42

What happens if too much NaFL is instilled, when evaluating CL?

Answer 42

Obscures Fluorescein pattern

Question 43

What is the purpose of the Wratten #12 yellow filter?

Answer 43

Enhance view by eliminating unwanted wavelengths

Question 44

In a steep fit, a smaller central NaFL pool indicates a ___ (very/slightly) tight lens.

Answer 44

Very