prescribing order, indication of CL

Question 1

What is the prescribing order of CL

Answer 1

1. Initial visit: preliminary examination to establish patient needs, expectations and suitability (e.g personal ocular or general health, success rate of CL history , lifestyle, occupational and environment factor )
2. Trial fitting and placing order
3. Delivery/ dispensing; compliance rule, lens care regimen (if any), aftercare visit
4. Aftercare visit – troubleshoot complain, lens fitting assessment, SLE of anterior eye for signs of complication, reinforce instruction, and scheduling of next follow up

Question 2

Based on the OOB guideline what is the Aftercare frequency

Answer 2

1st aftercare - 1 week after delivery
2nd - 1 month after 1st aftercare
subsequent - 3-6 months after 2nd
seasoned wearer - every 6 months if there is no change to lens type or material

Question 3

CL indication

Answer 3

• High ametropia
• Anisometropia
• Trichiasis
• Failures with refractive surgery
• Job requirement; stage performers, flight attendance, professional sportsman
• Cosmetic application – avoid spectacle, changing eye colour
• Medical reason – bandaging scar / cure of keratoconus / myopia control
• Enhancing performance – colour perception, reduce photophobia, block UV rays etc.
• Cannot accept wearing spectacles
• Others; sport, hobbies and occupation

Question 4

Contraindication of CL

Answer 4

• Low rx (+1 & <-0.75)
• VA worsen with lens
• Irregular astigmatism (contraindication for SCL)
• Prism required horizontally or more than 3 vertical prism
• Occupation; pilots, fire brigade, chemical lab technician
• Active infection/ pathology
• Chronic allergies and antihistamine, systemic disease which complicates contact lens wear, autoimmune disease/ immunocompromised
• Poor tear quality and quantity
• Giant papillary conjunctivitis
• Cannot accept the idea lens in eye / tolerate discomfort/ total perfectionist
• Poor hygiene, lack motivation , dry , dusty environment