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Contact Lens 3 > Prosthetics e-lectures > Flashcards

Prosthetics e-lectures Flashcards

1
Q

procedure where the entire eyeball is removed

A

enucleation

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2
Q

procedure with removal of eyeball’s contents and leaving the scleral shell intact, EOMs may still be attached

A

Evisceration

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3
Q

procedure with removal of all orbital contents including eyeball, extra ocular muscles, fat and connective tissues where sometimes the eyelid is removed as well and the maxilla (upper jawbone and cheek)

A

Exenteration

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4
Q

it is hard to differentiate with these two types of post-surgical eyes?

A

enucleation with implant vs. evisceration (without implant)

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5
Q

enucleation without implant appears as

A

an empty socket

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6
Q

when do you use a scleral shell or prosthetic scleral shell?

A

Phthisis bulbi: ocular end stage disease

atrophy, shrinkage, and disorganization of the eye ball and intraocular contents

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7
Q

prosthetic eyes are made of a curved disc of plastic with a min center thickness of

A

2mm

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8
Q

what are some ways to help tell if a prosthetic is a right or left side?

A
  • nasal edge is more pointy
  • superior trochlear curve
  • steeper superior F2 curve
  • flatter inferior F2 curve
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9
Q

a shell eye is a curved disc of plastic with a center thickness of

A

less than 2mm

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10
Q

a shell eye is designed to cover:

A

an intact eye or shallow socket

it may have open pupil for light perception

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11
Q

reasons to get implant vs. no implant

A
  • implant: allows for smaller ocular prosthetic

- no implant: fewer complications

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12
Q

reasons to get solid vs. porous implants

A

solid: fewer complications

porous (integrated implants): better motility, allows fibrovascular growth

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13
Q

what are two orbital implant complications?

A
  • migration: (movement of implant laterally or vertically)

- extrusion: (implant boring out of conjunctival surface)

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14
Q

is occlusion necessary in a routine eye exam on a prosthetic patient?

A

no

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15
Q

what are some things to check for in gross evaluation of prosthetic eye

A
  • binocular eye alignment
  • vertical palpebral fissure size and symmetry
  • iris diameter and color symmetry
  • pupil diameter (habitual eye, bright and dim)
  • sclera color (white, vessels)
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16
Q

how often should a prosthetic be replaced?

A

5-7 years

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17
Q

what are some prosthetic specific examination components?

A
  • eyelids: symmetry and vertical palpebral fissure height
  • iris: natural iris color, HVID, Nevus
  • cornea: opacity, arcus, etc.
  • pupil size: dim, moderate, and bright illumination
  • strabismus
18
Q

prosthetic eye fitting: step 1

A
  • determine ideal white or clear shape
  • examine overall socket shape (foveal, triangular, other)
  • diagnostic fitting vs. injection molding
19
Q

prosthetic eye fitting: step 2a

A

finalize overall shape, comfort, fit, (-) rotation

20
Q

prosthetic eye fitting: step 2b

A

prosthetic scleral shell

  • gross evaluation: adequate tear exchange, excessive blanching, bubbles are acceptable, excessive edge lift
  • biomicroscopy: ocular surface staining
21
Q

prosthetic eye fitting: step 3

A

determine color and shape

color match iris and sclera, iris position and size, pupil size

22
Q

prosthetic eye fitting: step 4

A

dispense, follow ups (2-4 weeks for initial shape, six month for polish, and annual examination)

23
Q

what are some common prosthetic complications?

A
  • blepharitis
  • conjunctivitis
  • incomplete eyelid closure
  • natural iris and scleral color changes
24
Q

problem with scleral shells (acrylic)

A

made of plastic (PMMA), but could not wear for extended periods of time due to no tear exchange

25
Q

pros and cons to introduction of corneal PMMA contact lenses

A

smaller design allowed for tear exchange and O2 transmissibility via movement, but movement would cause shifting of iris print

26
Q

examples of when to use of specialty contact lenses for non-functioning eyes

A

-opacified cornea
-iris atrophy
-white pupil
-corneal scar
etc.

27
Q

examples of when to use of specialty contact lenses for functioning eyes

A

-iris atrophy (large pupil)
-strabismus
-corneal scar (not in visual axis)
etc.

28
Q

definition of “iris occlusion”

A

iris pigment on the lens. pupil is clear/open

29
Q

definition of “pupil occlusion”

A

black pupil at the center of the lens. no vision

30
Q

definition of “iris and pupil occlusion”

A

iris pigment on the lens and black pupil at the center of the lens

31
Q

tinted SCL (A)

A
  • uniform color, no iris details

- translucent

32
Q

printed SCL (B)

A
  • ready-made or stock lens
  • manufactured, some iris details
  • opaque
33
Q

hand-painted SCL (C)

A
  • made to order, custom iris details

- opaque

34
Q

what are some characteristics of tinted lenses?

A
  • homogenous
  • translucent
  • unlimited base curve, power, diameters, iris and pupil diameters
  • best for matching dark eyes
35
Q

what are some other uses for tinted lenses?

A
  • red/green color deficiencies
  • achromatopsia
  • low vision patients
36
Q

what are some characteristics of printed lenses?

A
  • iris details
  • complete occlusion possible
  • limited BC, power diameters, and iris/pupil diameters
  • best for matching all eyes
  • replicable
  • fitting set available
37
Q

what are some characteristics of hand painted lens characteristics?

A
  • iris, pupil, scleral details
  • complete occlusion
  • unlimited BC, PWR, diameters, iris and pupil diameters
  • best for matching all eyes
38
Q

you should only use clear care for what type of lens

A

hand painted lenses

39
Q

what are some ocular disfigurements patients may want to conceal

A
  • iris abnormality: coloboma, scar, irregularity
  • corneal abnormality: scar, band keratopathy
  • pupil abnormality: white pupil
40
Q

what are some reasons patients may want to improve visual function with prosthetic lenses?

A
  • iris abnormality: traumatic iris atrophy, aniridia

- symptoms: glare

41
Q

reasons for an iris occluding (open pupil) lens:

A
  • albinism: lacking iris color
  • aniridia: lacking an iris
  • coloboma: iris opening (usually inferior)
  • iris atrophy/ fixed dilated pupils: abnormal pupil function
42
Q

reason for pupil occlusion (with or without iris details)

A
  • ambylopia: patching of the good eye
  • diplopia: binocular double image which cannot be suppressed or fused
  • leukocoria: white pupil, usually from posterior ocular scar tissue
  • corneal abnormalities: corneal scar, band keratopathy
  • strabismus: occluding one eye
  • achromatopsia: patients with rod-cone dystrophy
  • color vision difficulties: red magenta lens

Contact Lens 3 (3 decks)

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