Unit 2 Flashcards
Assess Patient Suitability
- Expectations
- Hobbies
- Work Environment
- Medical History
- Ocular History
- Wearing History
- Patient history is critical in determining???
◦ Whether a patient is suitable for contact lens wear
◦ To aid in selection
◦ To inform on management
Expectations
◦ Motivation for contact lenses
How he/she intends to use the lenses
◦ Expected wear time
◦ Replacement frequencies
◦ Expected visual outcome; most important for presbyopic patients
◦ Fitting process
Time involved
◦ Costs
Fitting, lenses
- Hobbies
◦ Discuss any hobbies or sports during which the patient intends to wear the lenses
Soft, hybrid, and scleral rigid lenses are less likely to become dislodged
Swimming is not recommended
–If necessary, a daily disposable lens with immediate replacement
◦ Eye protection, goggles, or safety glasses are still required ◦
- Work Environment
◦ Long-term computer use
◦ Dust and debris Esp. for RGPs
◦ Chemical fumes
◦ Safety glasses are still required
- Medical History
◦ Conditions and medications can change tear chemistry
Allergies
Pregnancy, menopause
Thyroid
Hyperthyroid- eyes are protruding more
Hypothyroid
–Eyelid position
Autoimmune diseases
–Inflammation
Dermatological conditions (seborrheic dermatitis, atopic eczema, acne rosacea)
Patient’s own physical capabilities
Diabetes
–Prone to infection and poor healing
–Reduced corneal sensitivity
Medications
Antihistamines, decongestants
Acne medications
Diuretics
OCP, Hormone replacement therapies
Anti-anxiety/depressants
Beta blockers
Chemo
- Ocular History
◦ Last eye exam
◦ Previous ocular surgery or trauma
Esp. refractive surgery
◦ History of ocular infection
◦ Visual acuity
◦ HVID
◦ Refraction
Astigmatism
High myopia
Presbyopia ◦ Keratometry
◦ Topograpy; a map of the cornea (any irregularities/steepness)
◦ Slit lamp; lids, lashes, conjunctiva etc..
- Wearing History
◦ Satisfaction
◦ Current lens parameters
Brand / type of lens worn (beware of poor recall!)
◦ Wear schedule
Average daily wear time (hours per day, days per week)
Sleeping in lenses
◦ Replacement frequency
◦ Care regimen
Advantages of CL
-Field of view- plus vs minus lens characteristics
-Better for anisometropia- Different prescription in each eye; image size difference issue with glasses
-Stays in place, don’t have to keep adjusting
-improves your side vision because of how it fits perfectly in your eyes
-No glare
-Wider field of view (frames are no longer in field of vision)
-Sports
-Weather
-Irregular cornea
-Less convergence for hyperopes at near
-No prismatic effect
Disadvantage of CL
-Fitting time and adaptation
-Lens handling skills
-Risk of infection
-Outdoor or office environment
-Unable to current some BV (binocular vision) problems
-Greater convergence by myopes at near
-Expensive
-Limited UV protection and tints