RGP fitting Flashcards

1
Q

Types of RGP lenses

A
  • corneal
  • corneal/scleral
  • mini scleral
  • scleral
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2
Q

Corneal RGP Advantages + Disadvantages

A

ADVANTAGES:
- robust
- easy to clean + handle
- stable vision
- good O2 supply
- dehydration lens problematic
- customised design
- good tear exchange

DISADVANTAGES:
- physical comfort
- greater movement
- FB entrapment

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3
Q

When to choose an RGP

A
  • moderate corneal astigmatism
  • complex rx
  • hx of allergies
  • problems with SCL
  • financial
  • poor compliance
  • high visual demands
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4
Q

When to avoid an RGP

A
  • contact sports
  • water sports
  • dusty environment
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5
Q

RGP parameters

A
  • BOZR 1/1.5mm smaller TD
  • FOZR 0.5mm larger than BOZR
  • centre thickness - too thin causes fledge
  • edge lift prevents mechanical pressure on cornea
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6
Q

RGP tear lens

A
  • power increases by +0.25DS for each 0.05mm that BOZR is steeper
  • BVP needs to be changed by -0.25DS for each 0.05mm to compensate
  • opposite is also true
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7
Q

Spherical vs Aspherical

A

Spherical - spherical back optic zone with spherical peripheral zone

Aspheric - elliptical lens design gradual flattening from centre out

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8
Q

Steps in selecting a first lens

A
  1. find corneal shape/size/pupil/rx/health
  2. choose separate lens type
  3. work out shape you want
  4. once shape selected - work out power using BVP calculation
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9
Q

Steps in selecting RGP material

A
  1. O2 requirement - Dk - thin lens - increased O2 - thick lens = less O2
  2. centre thickness
  3. wettability
  4. flexure can cause residual astigmatism
  5. compliance - if poor go for easy care materials
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10
Q

Common RGP materials

A
  • silicone acrylate
  • flourosilicone acrylate - better wettability
    -flourosilioxanyl sterene
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11
Q

BOZR considerations + calculations

A
  • difference in k readings is less than / equal to 1.00DC - then to flattest k
  • BOZR = flat k - (flat k - steep k) /3
  • round to nearest 0.05mm
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12
Q

What is an alignment fit

A
  • good centration/constant pupil coverage
  • no limbal crossing
  • adequate movement on blink
  • central trace of NaFl
  • mid peripheral adequate band of bright NaFl
  • peripheral adequate band of bright NaFl
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13
Q

What is a steep fit

A
  • good centration/ constant pupil coverage
  • no limbal crossing
  • minimal movement on blink
  • central NaFl pooling / bright area
  • mid peripheral wider band of touch
  • peripheral narrower than 0.5mm edge lift

CORRECTION
- flatter BOZR
- decrease BOZD
- thicker lens
- reduce TD to increase mobility

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14
Q

What is a flat fit

A
  • poor centration
  • limbal crossing
  • increased movement on blink
  • central area of dark
  • mid peripheral clearance
  • peripheral wider band of edge lift

CORRECTION
- steepen BOZR
- increase TD to stabilise lens
- use thinner lens to reduce eye movement
- BOZD increased by 0.05mm - BOZR requires to be flattened by 0.05mm

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15
Q

Lid attached fit

A

Upper edge of lens tucked under top lid during blink
- common in larger TD
- can actually be more comfortable as less lid interaction
- acceptable as long as pupil is covered

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16
Q

Over refraction

A
  • tells us about the fit
  • if good fit = o/r 0 as BVP is based on refraction
  • more plus/less minus = flat
  • more minus/ less plus = steep