Lesson 23 - Contact Lens-Related Conditions and Pathology

Question 1

Dry eye

Answer 1

A subjective symptom of frequent scratchy, burning, and/or irritated sensation of the eyes diagnosed at the slit lamp with fluorescein dye.

Causes: Dry eye is more frequently found in women due to hormonal changes. It can also be caused by antihistamines, antipsychotic medications, diuretics, medications for high blood pressure, dehydration, frequent computer viewing, Vitamin A deficiency, windy conditions, air conditioning, or autoimmune disease.

Question 2

Lens awareness

Answer 2

A subjective symptom of a frequently felt contact lens edge with the blink; should be differentiated from any other eye infection or condition.

Causes: Among many causes, these may include a chipped or torn lens, lens too tight or too loose, a dirty lens, an eyelash, or a cornea issue.

Question 3

Fluctuating or blurry vision

Answer 3

A subjective complaint of poor vision that may not not always be occurring or noticed (fluctuating).

Causes: May or may not be contact lens-related

Question 4

Pain

Answer 4

A subjective patient symptom that may or may not be contact lens related; cause must be diagnosed by the doctor.

Causes: Depends on location and where the pain source is

Question 5

Photophobia

Answer 5

A subjective symptom when the patient reports light sensitivity with or without contact lenses. The cause must be diagnosed by the doctor.

Causes: Usually corneal swelling resulting from the lens being worn too long or the lens being too tight

Question 6

Steep or flat lens

Answer 6

Objective finding to describe how the lens fits over the cornea. Use of a slit lamp is required for diagnosis.

Question 7

Everted lens

Answer 7

A procedure that involves turning an eyelid inside out to visualize the tarsal plate or palpebral conjunctiva

Question 8

Cornea/conjunctival staining

Answer 8

Objective term to describe the cornea or conjunctiva when fluorescein dye (stain) is used to diagnose or look for abnormalities

Question 9

Injection

Answer 9

Objective term used to describe when excess blood vessels on the conjunctiva or sclera appear engorged with blood

Question 10

Corneal edema

Answer 10

Objective term used to describe when the cornea is swollen

Question 11

Discharge

Answer 11

Objective term used to describe when there is mucus or watery fluid produced by the eye

Question 12

Vision loss

Answer 12

Objective term used to describe any condition that causes a decrease in vision or worsening of vision

Question 13

Blepharitis

Answer 13

An eyelid bacterial infection

Question 14

Giant papillary conjunctivitis (GPC)

Answer 14

An inflammatory condition of the upper and lower palpebral lid tissue.

Side note: you may want to pay special attention to this condition. I remember seeing many questions about this when I took the NCLE/CLRE. However, your experience may vary.

Refer to the following link:
https://www.optometrists.org/general-practice-optometry/optical/guide-to-contact-lenses/what-are-scleral-lenses/contact-lenses-for-giant-papillary-conjunctivitis-gpc/

Question 15

Ptosis

Answer 15

Droopy eyelid

Question 16

Superior epithelial arcuate lesion (SEAL)

Answer 16

A corneal epithelial lesion in the superior part of the cornea

Question 17

Contact lens-associated red eye (CLARE)

Answer 17

Contact lens-related red eye that goes away after the contact lens is removed

Question 18

Vascularized limbal keratitis (VLK)

Answer 18

Inflammation of the cornea, limbus, and conjunctiva caused by contact lens wear

Question 19

Superior limbic keratitis (SLK)

Answer 19

Contact lens-related recurrent inflammation of the superior corneal limbal area

Question 20

Contact lens peripheral ulcer (CLPU)

Answer 20

A bacterial infectious corneal ulcer in the peripheral cornea usually associated with sleeping in or over wear of soft contact lenses.

Question 21

Dimple veiling

Answer 21

Numerous focal indentations on the cornea caused by trapped air bubbles under a contact lens

Question 22

Smile staining

Answer 22

A smile-shaped corneal epithelial lesion seen with fluorescein caused by soft contact lens dehydration

Question 23

Mucin balls

Answer 23

Small globules made of mucus trapped under a soft contact lens

Question 24

Microbial keratitis

Answer 24

Bacterial corneal infection

Question 25

Acanthamoeba keratitis

Answer 25

Serious painful infection of the cornea caused by an organism called Acanthamoeba

Question 26

Dendritic ulcer

Answer 26

A short branch-patterned ulcer on the cornea caused by a herpes infection

Question 27

Corneal infiltrates

Answer 27

Cornea immune response to inflammation caused by soft contact lens wear; white-gray lesions with feathery edges on the cornea

Question 28

Corneal dellen

Answer 28

Small depression at the corneal margin that may be spontaneous in the elderly or caused by a localized area of dehydration after cornea is compromised

Question 29

Corneal staining

Answer 29

Corneal defects that appear with fluorescein dye in a slit lamp

Question 30

Corneal molding/warpage

Answer 30

Another name for orthokeratology, the use of gas permeable lenses worn during sleep to reshape the cornea to reduce nearsightedness, farsightedness, and astigmatism

Question 31

Corneal warpage

Answer 31

Irregular corneal astigmatism and poor vision with glasses caused by soft contact lens wear

Question 32

Many of the eye problems and infections you will learn about from contact lens wear will result from what? However, there are also other sources of contact lens-related eye problems. List them

Answer 32

Many of the eye problems and infections you will learn about from contact lens wear will result from bacteria. However, there are also other sources of contact lens-related eye problems from viruses, fungi, histamines, reduced immunities, and improper use of contact lenses.

Question 33

Remember that bacteria live on our eyelids, lid margins, and eyelashes. Frequently, bacteria can also survive on eye makeup products, which is why eye infections are common who? Our tear film serves an important role in what? Good hygiene and proper cleansing of the eye and eyelid margins daily are important. why?

Answer 33

Remember that bacteria live on our eyelids, lid margins, and eyelashes. Frequently, bacteria can also survive on eye makeup products, which is why eye infections are common among those who sleep with or don’t remove their eye makeup before bed. Our tear film serves an important role in washing away much of the bacteria that enters the eye from the lids and lashes. Good hygiene and proper cleansing of the eye and eyelid margins daily are important in reducing risk for eye infections.

Question 34

Contact lens wearers are at a higher risk for eye infections since the lenses can also harbor bacteria, especially if what? ___ lenses are less likely to cause eye infections than soft lenses. ____ lenses have less risk of causing eye infections.

Answer 34

Contact lens wearers are at a higher risk for eye infections since the lenses can also harbor bacteria, especially if the lenses are not cleaned and disinfected well prior to inserting them. Gas permeable lenses are less likely to cause eye infections than soft lenses. Single-use soft contact lenses have less risk of causing eye infections.

Question 35

Important factors in avoiding eye infections.

Answer 35

Washing the hands prior to handling contact lenses or touching the eyes is also an important factor in avoiding eye infections. Of course, sharing contact lenses is especially dangerous, and using tap water or non-approved lens cleaners and solutions is a high risk for eye infections and problems.

Question 36

Subjective clinical findings

Answer 36

The word subjective means the findings are described based on the person’s personal opinion, experience, or their own ideas, without visible evidence assessed by the practitioner. Subjective clinical assessments are important to obtain during the contact lens fitting and when people come in with problems, because it is helpful to the doctor to understand where and how much the problem is bothering the patient.

Question 37

Objective clinical findings

Answer 37

Objective findings are findings that the doctor or optician fitting contact lenses may discover while examining the eye or checking a contact lens fit.