Medically Necessary CL's (F)

Question 1

What are the treatment options for vision correction for a bilateral aphakic? 1. Unilateral? 2

Answer 1

1. spectacles or contact lenses

2. contact lenses needed

Question 2

What were the conclusions of the IATS study?

Answer 2

1. no significant diff btw mean VA of IOL vs CL
2. significantly more adverse events and additional intraoperative procedures needed in IOL group
3. infants younger than 7mos with unilateral cataract should be left aphakic and use CL
4. primary IOL implantation only for those patients who could not successfully wear CL

Question 3

What are the locations of the cataracts on the lens that can be congenital or later onset?

Answer 3

1. cortical

2. lamellar

Question 4

What are the possible causes of aphakia?

Answer 4

1. post surgical congenital cataracts
2. post surgical acquired cataract
3. Marfan syndrome
4. trauma

Question 5

What is the lens option for aphakia that is silicone and has a surface treatment for wetability? 1. What are the issues with these? 2

Answer 5

1. Silsoft

2. can’t be handled often, only come in 3D steps, no cyl correction

Question 6

What is usually the cause of bilateral congenital cataracts? 1. Unilateral? 2

Answer 6

1. inherited or related to disease

2. idiopathic

Question 7

What is the disease that often leads to subluxation of the lens? 1. Is IOL implantation usually successful? 2

Answer 7

1. Marfan’s syndrome

2. no

Question 8

What are the essential properties that must be in gas permeable lenses for aphakia?

Answer 8

1. high Dk/t

2. UV protection

Question 9

What is the follow up schedule for contact lenses for aphakia?

Answer 9

1 week and 1 month

Question 10

What are the possible causes of acquired juvenile cataracts?

Answer 10

1. chronic ocular inflammation or steroid use
2. maternal infection (Rubella)
3. radiation
4. chronic retinal detachments (Stickler’s)

Question 11

What is the congenital condition that occurs in the capsule of the lens but is treated just like a cataract?

Answer 11

persistent hyperplastic primary vitreous

Question 12

What are the major indications for medically necessary contacts?

Answer 12

1. aphakia
2. corneal injury, scar or irregular cornea
3. nystagmus
4. anisometropia

Question 13

What are the locations of the cataracts on the lens that are usually congenital?

Answer 13

1. anterior polar
2. central fetal nuclear
3. posterior polar