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FS Lectures > Ophthalmology: Operational Contact Lenses > Flashcards

Ophthalmology: Operational Contact Lenses Flashcards

1
Q

Corneal Anatomy

A

Remember: the cornea is avascular (O2 from the atmosphere, nutrients from tears)

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2
Q

Benefits of contact lenses

A
  • Increased Field of View
  • Decreased Abberations
  • Increased Comfort
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3
Q

Cons of contact lenses

A
  • More care
  • More cost
  • More risk

Not a TRICARE covered benefit unless in the aviation community

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4
Q

Contact lenses are supported within the ____ ____.

A

tear film

Note: tear quantity/quality effects lens performance

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5
Q

Types of contact lenses

A
  • Rigid Gas Permeable (RBP aka GP)
  • Soft (SCL)
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6
Q

What are GPs primarily used for?

A

Corneal irregularities (e.g., keratoconus)

Note: GPs provide superior optics for visual acuity, but are difficult to get used to

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7
Q

Characteristics of SCLs

A
  • Default for aviation
  • Cover entire cornea (can be used as a bandage)
  • Silicone
  • Toric (astig) and Spherical options
  • Extended vs Daily
  • Vision may not be quite as good as with glasses or GPs
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8
Q

Poor fit or extended wear of contacts can cause…

A
  • Corneal Hypoxia
  • Corneal Edema
  • Corneal neovascularization
  • Change in refractive error/power
  • Increased risk of infection
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9
Q

CLs sit on the cornea, while glasses are ______ away from the corneal plane

A

12-13 mm (aka Vertex distance)

This is why contact prescriptions are NOT the same as glasses prescriptions

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10
Q
A

Fusarium Keratitis

80% of cases tied to poor compliance or bad hygienic practices

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11
Q

True/False

SNA applicants can be waived with uncorrected VA 20/400 if corrected to 20/20-0 with CLs

A

False

Used to be true, but no longer valid

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12
Q

Common Complications of CLs

A

Dry eye

Corneal neovascularization

Conjunctivitis

Sterile corneal infiltrate

Corneal Abrasion

Blepharitis

Corneal ulcer (microbial keratitis) = true emergency

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13
Q
A

Corneal ulcer aka Microbial Keratitis

Treatment = discontinue CL and 3rd/4th gen fluoroquinolone and cycloplegic drops (if unable to refer)

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14
Q

CLARE

A

Contact Lens Associated Red Eye

Treatment = d/c CL wear, prophylatic Abx until seen by Ophtho

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15
Q

Myopic spectacle lenses = ______ CL power

A

less

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16
Q

Hyperopic spectacle lenses = ______ CL power

A

more

17
Q

CL solution used for operational needs

A

Multipurpose (all in one cleaner/disinfection)

Note: NOT the same as saline solution and cannot be used with hard lens

18
Q

You should replace your CL cases every ______

A

3 months

19
Q

True/False

Daily Wear (CL) is required for Aviation

A

True

Exception: operational requirement necessitates flex wear (need a day of rest – no CL wear – after EW)

20
Q

Studies show _____ greater incidence of microbial keratitis with extended wear

A

10-15x

21
Q

True/False

Most eye drops can be used with CLs

A

False

22
Q

True/False

Members who wear CL must carry back-up spectacles during all flights and have CL wear notated on up-chit

A

True

23
Q

3 Requirements for CL wear

A
  1. Must meet VA standard with contacts on
  2. Contact lens usage must be authorized on up-chit
  3. Must fly with back up specs
24
Q

Telltale sign of wearing CL too often

A

Giant papillary conjunctivitis

“Every time I blink my contact moves around”

25
Q

Treatment for Blepharitis

A

Wash with baby shampoo

Warm compress

do NOT wear CL until it resolves

26
Q

Cells in anterior chamber are diagnostic of…

A

iritis/uveitis

27
Q

What labs should you check if a pt presents w/ corneal arcus (senilis)

A

Lipid panel

28
Q

Pinguecula vs Pterygium

A

Pinguecula = yellowish patch/bump on the medial conjunctiva

Pterygium = growth of fleshy tissue on the conjunctiva that extends over the cornea (often arising from a pinguecula)

29
Q

Most common type of CLs in Naval Aviation

A

Soft (SCL)

Silicone hydrogels that cover entire cornea

30
Q

Treatment for CL wearer with negative fluorescein stain (NaFL) but underlying haze?

A

Think Sterile Corneal Infiltrate

Discontinue CL wear

Non-preserved artificial tears

+/- Abx (unable to refer or concerned for infection vs inflammation)

31
Q

Can you use multipurpose solutions with extended wear CLs?

A

Yes

All in one cleaner/disinfectant (rub lenses 10-15s, put in case and fill with solution)

32
Q

Pros to CL wear

A

Increased Field of View

Decreased Abberations

Increased Comfort

33
Q

3 things needed to fly with CLs

A
  1. Must meet VA standard with contacts on
  2. CL usage authorized on upchit
  3. Must fly with back up specs
34
Q

3 conditions caused by poorly fitted CLs

A
  1. Corneal Hypoxia
  2. Corneal Edema
  3. Corneal Neovascularization

Also causes change in refractive error/power and increased risk of infection

FS Lectures (9 decks)

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