intro and history Flashcards

1
Q

horizontal radii is 43.5
vertical radii is 45.5

What type of astigmatism is that?

A

with the rule

horizontal has weaker power

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2
Q

Your patient’s flat corneal radius (Flat K) is 40.50 D. What is the equivalent?

A
  1. 33 mm

337. 5/r (will convert Diopter to mm)

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3
Q

patient corneal radius (Flat-K) is 51.00 D. What is correct?

A

cornea with keratoconus
*high focal power, unusually steep

also, possible for refractive surgery, but not likely

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4
Q

What is the relationship between radius and diopter?

A

inversely related

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5
Q

What is an average cornea HVID and VVID?

A

HVID 11.70

VVID 10.60

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6
Q

What slitlamp illumination technique is used to observe CORNEAL LAYERS (therefore also tearfilm thickness and lens thickness in CL)?

A

optic section

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7
Q

What is the appropriate thickness of the corneal epithelium?

A

50 microns

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8
Q

What is the thickness of the total cornea?

A

520 microns

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9
Q

What is the appropriate water content of the cornea?

A

78%

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10
Q

How dose the cornea react under oxygen deprivation? (fast reaction)

A

edema

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11
Q

• One of the most important properties of a contact lens material
• Inherent material property
• Not a function of lens thickness, shape or back
vertex power
• D = diffusion coefficient of the material
• k = solubility of the gas in the material

A

oxygen permeability Dk

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12
Q

What specifies contact lens material?

A

Dk/t

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13
Q

What is the SI unit of Dk?

A

1 Barrer (10-11 (cm3 O2 cm)/(cm3 sec mmHg)

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14
Q

What is an acceptable minimum Dk/t value to avoid corneal edema?

A
  • Daily wear: Dk/t = 24

* Extended wear: Dk/t = 87

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15
Q

What is an acceptable minimum Dk/t value to avoid anoxia for open and closed eye?

A
  • Daily wear: Dk/t = 35

* Extended wear: Dk/t = 125

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16
Q

What type of measurements are Dk and Dk/t?

A

indirect in vivo measurements which infer oxygen transmissibility

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17
Q

What goes along with cornea edema?

A

swelling and change in k readings

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18
Q

Oxygen concentration of a gas mixture which produces an equivalent corneal response

A

equivalent oxygen percentage (EOP)

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19
Q

Wettability is crucial for what?

A

comfort and vision

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20
Q

How is wettability detected?

A

• Can be detected in vitro and in vivo

21
Q

In vitro = ?

A

wetting angle

22
Q

3 ways to measure wetting angle

A

A. Sessile drop
B. Captive bubble
C. Wilhelmy plate

23
Q

What type of angle is a good wetting angle?

24
Q

What are in vivo measurements for wettability?

A
  • Tear coverage
  • Break-up time
  • Drying time
25
What type of treatment can improve wettability?
plasma treatment (super cleaning)
26
plasma treatment
• Plasma cleaning • Ionized gas (oxygen) • Around room temperature • Plasma interacts with any surface • Plasma’s UV energy is very effective in the breaking organic bonds • Super cleaning—lasts a few days to months
27
What does the human tearfilm contain?
Mucin, lipids, lactoferrin, lysozyme
28
Class I devices
* Are deemed to be low to moderate risk * Subject to the least regulatory controls * Example: dental floss
29
• Class II devices
• Are moderate to high risk • Require greater regulatory controls to provide reasonable assurance of the device’s safety and effectiveness • General controls and special controls • Examples • Contact lenses worn during daytime (soft, GP, care products) ex: condoms
30
• Class III devices
* Are high risk * Most stringent regulatory controls * General controls and pre-market approval (PMA) * Examples * Extended wear contact lenses * Overnight orthokeratology lenses
31
• National requirements (Federal State Law)
• All prescriptions for corrective lenses must be released to patients, whether requested or not
32
• Eyeglass rule (Federal State Law)
• Eyeglass prescriptions must be given to the patient | immediately following the eye exam
33
• Contact lens rule (FCLCA)
• Contact lens prescriptions must be given to the patient immediately upon completion of the eye exam or the contact lens fitting (if a fitting is necessary) • Contact lens fitting means the process that begins after an initial eye examination for contact lenses and ends when a successful fit has been achieved • In cases of renewal prescriptions, the fitting ends when the prescriber determines that no change in the existing prescription is required
34
California State Law regarding valid CL Rx
• Requires a valid contact lens prescription include • Power, material or manufacturer or both, base curve or appropriate designation, diameter (when appropriate), and an appropriate expiration date • The prescription should also include • Patients name • Optometrists name, address, telephone number, license number, and signature
35
California State Law regarding internet sites
should ask for information about your doctor so they may verify the prescription with the doctor • California law requires them to do this if they don’t have a copy of the written prescription • If the company does not ask for this information, they are not complying with state law
36
California State law regarding copy of CLs
• In exchange for a copy of the contact lens prescription, prescribers CANNOT require patients to • Buy contact lenses • Pay additional fees • Sign a waiver or release
37
CSL regarding third party
* If a patient elects to purchase contact lenses from a third party, the seller must verify the prescription before filling it * When requested, optometrists are required to respond to sellers’ requests for prescription verification within eight business hours * ‘passive verification’
38
CSL regarding detailed Rx
• More detailed prescriptions will include directions for safe use such as • Wearing schedule • Whether the lenses are for daily or extended wear • Number of refills • Whether lens material substitutions are allowed
39
CSL regarding verification
• More detailed prescriptions will include directions for safe use such as • Wearing schedule • Whether the lenses are for daily or extended wear • Number of refills • Whether lens material substitutions are allowed
40
Pt: +2.00 DS soft CL VA decreased over the lens keratometry, the mires are irregular. What is the most likely reason?
lenses are inside out theoretically: we can find this in: keratoconus (associated in myopia, not +2.00 lens) or irregular astigmatism (should be fit with GP CLs)
41
pt: -2.00 DS GP CL over the lens keratometry: -0.75 x 180 Why is that?
Lens flexure
42
Why is n=1.3375 for the cornea?
cornea is considered a single surface
43
pt spectacle lenses (12 mm from cornea): -10.00 D What is his CLs power?
-9.00 D
44
power rule for glasses/contacts changing
If Rx is 10.00 D, then the power change will be 1 D change either more or less depending
45
Daily wear CL should have at least what Dk/t value?
24
46
Extended wear CL should have at least what Dk/t value?
87
47
What is a true description for plasma treatment of lenses?
intense surface cleaning
48
What is an example of an in-vivo test of CL wettability?
TBUT