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Contact lenses year 3 > revision and contact lens routine > Flashcards

revision and contact lens routine Flashcards

1
Q

what are the 2 main contact lens routines

A
  • new fit

- aftercare

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2
Q

list the 3 main stages that a new fit consists of

A
  • baseline measurements
  • teaching insertion and removal (done after the fitting appt)
  • lenses given for a trial period
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3
Q

list the 4 main attributes that can be linked to a aftercare

A
  • px in an existing wearer
  • routine check or unscheduled visit e.g. a problem
  • you may detect a problem in an asymptomatic patient
  • might need a refit
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4
Q

list 6 reasons for conducting an aftercare

A
  • assess the ocular reaction to a lens
  • answer patient queries/questions
  • address any compliance issues
  • safety - reduce risk of infection
  • ensure optimum comfort and optical performance
  • minimise drop outs
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5
Q

why will you assess the ocular reaction to a lens during an aftercare

A

as it may not happen straight away, but a few months after

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6
Q

list the 11 steps of a new fit from beginning to end

A
  • check initial details
  • history and symptoms
  • anterior eye slit lamp and lid eversion
  • preliminary measurements
  • select and insert lens
  • va, overrefraction, balance
  • lens fit
  • post lens removal and slit lamp check
  • advice and recommendations
  • book teach
  • trial lens specification
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7
Q

list the 8 steps of an aftercare from beginning to end

A
  • check initial details
  • history and symptoms
  • va, overrefraction, balance
  • lens fit
  • remove lens, insert NaFl
  • anterior eye slit lamp and lid eversion
  • advice and recommendation
  • final specification
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8
Q

what 3 points needs to be checked when checking initial details

A
  • valid spectacle prescription
  • during aftercare you also need to know the contact lens prescription as well as spectacle prescription
  • check the recall dates
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9
Q

why do you need a valid spectacle prescription before carrying out a new fit or aftercare on a px

A

because you can guess what power lens to put in and you also know that the posterior eye has been checked

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10
Q

during a new fit, what will you ask for their reason for visit

A
  • their sensible motivation for wear…cosmetic, sport, special occasion?
  • the patients expectations e.g. FT wear or occasional wear
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11
Q

during an aftercare, what will you ask for their reason for visit

A
  • isit routine or unscheduled visit
  • determine if there are any problems
  • follow up any advice from their previous visit (so need to know if any advice was given before)
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12
Q

when measuring dist va and near va during a new fit, what 3 points do you have to consider

A
  • to check it with the specs on
  • do they have any amblyopia
  • do they have any presbyopia
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13
Q

when measuring dist va and near va during an aftercare, what 4 points do you have to consider

A
  • vision must be good with contact lenses
  • vision must be good with specs
  • how is their visual stability with the contact lenses throughout the day
  • the onset of presbyopia
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14
Q

what two things can cause visual stability problems with contact lenses

A
  • fluctuation: px has to blink to make the lens clear = fitting problem
  • is the lens the correct way around?
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15
Q

what 2 points do you have to consider during a new fit, when asking a px about their current ocular health

A
  • check for any symptoms: if so, treat the pre-existing symptom before doing the fit
  • contraindications to lens wear
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16
Q

what 4 points do you have to consider during an aftercare when asking current ocular health

A
  • any new problems?
  • comfort: any issues when wearing CLs?
  • Qus about lenses: age of lens/case, cleaning of lens/case, solution (px may have switched to another brand)
  • wear times: days, hours, max, average, today
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17
Q

what 4 main symptoms are considered as an ocular emergency

A
  • light sensitivity
  • discharge
  • pain
  • vision suddenly blurry/loss

but ask questions first

18
Q

which part of the anterior eye is considered most important

A

the cornea

19
Q

what 5 points will you ask a px about their symptoms during history and symptoms

A
  • when
  • onset
  • triggers: what causes the symptoms/associations
  • severity
  • how
20
Q

list 5 times a px can have symptoms when asking ‘when’ they suffer from these symptoms

A
  • on insertion: e.g. hands not clean
  • during wear
  • end of wear
  • after removal: can be probs with eye itself
  • beginning of month/end of month: e.g. deposits, lens not clean
21
Q

what do you need to consider/ask when asking about the onset of a px’s symptoms

A
  • how recent: days? weeks?

- longstanding - check previous records. Has there been a change in symptoms?

22
Q

what questions would you ask a px about when asking about the severity of their symptoms

A
  • ask px to grade on a scale of 1-10

- how long does the symptoms last for

23
Q

what 2 things do you have to consider when asking about previous ocular history during both a new fit and an aftercare

A
  • have they ever suffered from any eye conditions?

- establish if there is anything which might limit the px’s wear, lens type, or require more frequent monitoring?

24
Q

what three things do you need to know during previous ocular history during a new fit

A
  • reason for ceasing wear
  • previous lens details
  • previous problems
25
Q

what two things do you need to know during previous ocular history during an aftercare

A
  • check previous records and confirm

- anything new which has occurred since the previous visit

26
Q

give two reasons why you will ask about any allergies or general health during a new fit or aftercare

A
  • contraindications to wear

- increased risk to ocular infection/ocular discomfort: e.g. diabetic px takes longer to heal

27
Q

what lifestyle questionnaires would you ask a px during a new fit

A

does the patient intend to smoke, use VDU and how much, drive, hobbies and occupation whilst wearing their lenses

28
Q

what lifestyle questionnaires would you ask a px during an aftercare

A

is the px wearing lenses when, smoking, using VDU, driving, during hobbies and their occupation

29
Q

what do you do when observing the anterior eye using the slit lamp with white light

A
  • lid eversion
  • use grading scale and state the scale used
  • record baseline data for medico-legal requirements
  • enhance visibility of blood vessels using red free filter (green)
30
Q

what do you do when observing the anterior eye using the slit lamp with blue light

A
  • check with flourescein sodium and cobalt blue filter

- measure TBUT

31
Q

which filter can you use to enhance flourescein visibility

A

wratten 12 filter (yellow)

32
Q

list the 4 things you must record when checking staining

A
  • location (central is worse)
  • extent
  • depth (using optic section)
  • type (confluent, punctate)
33
Q

list 4 preliminary measurements that must be taken on all patients, new and existing and why

A
  • HVID
  • IP
  • pupils
  • keratometry

incase the existing px has developed a problem, previous measurements may have changed

34
Q

how must you mature pupils on a px and what must you comment on about them

A

in dim lighting and room lighting

- comment on: size, shape and reactions

35
Q

how must you measure visual acuity on a contact lens px

A

perform an over refraction:

  • check mono VA’s
  • push the plus - give minus if improves acuity
  • sph/cyl correction if required
  • +1.00DS blur test/duochrome

binocular balance

36
Q

what 2 things do you check with a binocular balance on a pre-presbyope

A

accommodation and near VA

37
Q

what 2 things do you check with a binocular balance on a presbyope

A

near VA and near add (required to achieve N5 at px working distance)

38
Q

list the advice and recommendations required after a new fit

A
  • explain: if eyes are suitable/unsuitable for contact lens wear
  • action plan: book teach appointment/address OH issues
  • recall: state weeks
39
Q

list the advice and recommendations required after an aftercare

A
  • explain: ocular health ok? lens wear ok? address any symptoms or signs
  • action plan: either continue with wear or treat signs and symptoms
  • recall
  • give specifications if appropriate
40
Q

what must you do if a px reports symptoms such as flashes and floaters

A

conduct a posterior eye exam

Contact lenses year 3 (15 decks)

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