UNIT 3: Follow Up Care Flashcards

1
Q

Subjective Analysis : Wearing Time

A
  • Consistency
  • At time of visit
  • Day before
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2
Q

Subjective Analysis : Vision and Comfort Problems

A
  • When do they occur?
  • Do they subside or become worse?
  • Feeling
  • Burning
  • Itching
  • Fogging
  • Slipping
  • Vision
  • Photophobia
  • Edge blur
  • Spectacle blue
  • Injection
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3
Q

Methods of Lens Care

A
  • Have the patient describe and demonstrate how
    they care for their lenses.
  • Correct and instruct as needed
  • Verify consistency of cleaning and disinfection
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4
Q

Types and Brands of Solutions Used

A
  • Have the patient bring all lens care solutions to each visit.
  • Compare to solutions originally dispensed
  • Check preservatives
  • Check compatibility of solutions
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5
Q

Objective Analysis : Soft Lenses

A
  • Visual Acuity:
    • Steep Lenses
    • Flat Lenses
    • Uncorrected astigmatism
    • Presbyopia - Near acuity
    • Dehydration - Environment, Medications
    • Deposits
    • Inside-out lens
  • Blinking
  • Biomicroscopy with lenses:
    • Lens Movement: Sclerotic Scatter, Direct
      • .5 - 1mm on upward gaze
      • Free movement, no conjunctival drag
    • Lens Position: Sclerotic Scatter, Direct
      • Full corneal coverage
      • 1mm beyond the visible iris
      • Lens defects: Direct, Retro
        • Splits
        • Nicks
      • Lens Deposits: Direct, Retro
        • Organic
        • Inorganic
      • Keratometry with lenses:
        • Quality of the mires
        • Stability of the mires
      • Retinoscopy with lenses:
        • Quality of the reflex
        • Stability of the reflex
  • Biomicroscopy without lenses:
    - Bulbar Conjunctiva: Direct, Indirect
    - Circumcorneal Injection
    - Cysts
    - Pingueculas
    - Cornea: Direct, Sclerotic Scatter, Retro,
    Specular Reflection
    - Neovascularization
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6
Q

Conjuctival Cyst

A
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7
Q

Pinguecula

A
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8
Q

Pterygium

A
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9
Q

Cornea Parallel Piped

A
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10
Q

Cornea: Sclerotic Scatter

A
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11
Q

Cornea: Specular Reflection

A
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12
Q

Cornea: Neovascularization

A
  • Blood vessel growth into the cornea
  • Causes:
    • Lack of O2
    • Stimulation of limbal vessels
    • Infection
    • Injury
    • Surgery
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13
Q

Circumcorneal Injection & Neovascularization

A
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14
Q

Neovascularization

A
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15
Q

Objective Analysis: Soft Lenses

A
  • Biomicroscopy without lenses:
    • Cornea:
      • Edema: Vertical Striae Polymegathism
      • Infiltrates, Ulcers
      • Staining:
        • Arcuate
        • SPK Superficial Punctate Keratitis
        • SLK Superior Limbic Keratoconjunctivitis
        • Foreign Body
        • Inferior Removal Stain
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16
Q

Vertical Striae, a series of parallel, whitish lines in the deep stroma

A
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17
Q

Polymegathism

A
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18
Q

Pseudominas Ulcer

A
  • Mascara, solutions, dirt, water, extended wear
    contact, weakened immune system (AIDS)
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19
Q

Acanthamoeba

A
  • Has been detected in contaminated water
    supplies, hot tubs and swimming pools/ it
    invades the cornea through an abrasion.
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20
Q

Inferior Removal Stain

A
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21
Q

Superficial Punctate Keratitis

A
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22
Q

Superior Limbic Keratoconjunctivits (SLK)

A
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23
Q

Objective Analysis: Soft Lenses

A
  • Keratometry without lenses:
    • Change in readings within 0.50 diopter
    • Quality of the mires
  • Lens Inspection:
    • Deposits
    • Discoloration
    • Damage
    • Power
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24
Q

Soft Lens Tear with Fungus

A
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25
Q

Soft Lens Deposits

A
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26
Q

Discolored Soft Lenses

A
27
Q

S.O.A.P.

A
  • Subjective Findings
  • Objective Findings
  • Action: Corrective Action
    • Refer for medical treatment
    • Change lens parameters or material
    • Lens care
    • Wearing schedule
  • Patient Instructions
28
Q

Objective Analysis: Rigid Lenses

A
  • Visual Acuity
    • Steep Lenses
    • Flat Lenses
    • Uncorrected Astigmatism
    • Presbyopia: Near Acuity
    • Dehydration: Environment, Medications
    • Deposits
  • Blinking
  • Biomicroscopy with Lenses:
    • Lens Movement: Sclerotic Scatter, Direct:
      • Good Movement with Blink
      • Rapid return to centered or slightly superior
        position following blink
    • Lens Position: Sclerotic Scatter, Direct
      • Interpalpebral: Centered
      • Lid Attachment: Slightly Superior
29
Q

Lid Attachment

A
30
Q

Interpalpebral

A
31
Q

Objective Analysis: Rigid Lenses

A
  • Biomicroscopy with Lenses:
    • Lens Defects: Direct, Retro
      • Scratches
      • Nicks
      • Non Wetting Surface
    • Lens Deposits: Direct, Retro
      • Organic
      • Inorganic
32
Q

Scratched GP Lens with Deposits

A
33
Q

Scratched GP Lens

A
34
Q

Non- Wetting GP Lens

A
35
Q

Sclerotic Scatter with GP Lens Deposits

A
36
Q

Objective Analysis: Rigid Lenses

A
  • Fluorescein Patterns
    • Peripheral clearance
    • Alignment
    • Steep
    • Flat
37
Q

Steep GP Fluorescein Pattern

A
38
Q

Objective Analysis: Rigid Lenses

A
  • Keratometry with lenses:
    • Quality of the mires
    • Stability of the mires
    • Amount of astigmatism
  • Retinoscopy with lenses:
    • Quality of the reflex
    • Stability of the reflex
39
Q

Objective Analysis: Rigid Lenses

A
  • Biomicroscopy without lenses:
    • Lid Margins: Direct, Indirect
      • Meibomian glands, lacrimal lake
    • Palpebral Conjunctiva: Direct, Indirect
      • Cysts
      • Injection
      • CPC (Upper)
40
Q

Healthy Eye

A
41
Q

Lid Margins

A
42
Q

Giant Papillary Conjunctivitis

A
43
Q

GPC with Fluorescein

A
44
Q

Objective Analysis: Rigid Lenses

A
  • Biomicroscopy without Lenses:
    • Bulbar Conjunctiva: Direct, Indirect
      • Circumcorneal Injection
      • Cysts
      • Pingueculas
    • Cornea: Direct ( Parallel Piped, Optic Section ),
      Sclerotic Scatter, Retro, Specular Reflection.
      • Neovascularization
45
Q

Circumcorneal Injection & Neovascularization

A
46
Q

Neovascularization

A
47
Q

Objective Analysis: GP Lenses

A
  • Biomicroscopy without lenses:
    • Cornea:
      • Edema: CCC ( Central Corneal Clouding ),
        Microcysts
      • Infiltrates, Ulcers
      • Staining :
        • Arcuate
        • SPK ( Superficial Punctate Keratitis )
        • 3:00 - 9:00
        • Central abrasion
        • Foreign body
        • Dimple Veiling - Bubbles
48
Q

Central Corneal Clouding

A
49
Q

Microcysts

A
50
Q

Bacterial Ulcer with Hypopon

A
51
Q

Arcuate Staining

A
52
Q

Arcuate Staining

A
53
Q

3:00 & 9:00 Staining with Dellen

A
54
Q

Cornea: Keratitis Sicca

A
  • Also known as Keratoconjunctivitis Sicca
  • Several Possible Causes:
    • Reduced function of the lacrimal glands
    • Excessive evaporation of tears
    • Mucin deficiency
  • Tests:
    • Rose Bengal, Schrimer
    • Tear Break Up Time
    • Lacrimal Lake
55
Q

Keratitis Sicca with Rose Bengal

A
56
Q

Tear Break Up Time

A
57
Q

Corneal Dryness

A
58
Q

Central Abrasion

A
59
Q

Foreign Body Staining

A
60
Q

Dimple Veiling

A
61
Q

Dimple Veiling

A
62
Q

Objective Analysis: Rigid Lenses

A
  • Keratometry without lenses:
    • Change in readings with 0.50D
    • Quality of the mires
  • Lens Inspection:
    • Deposits
    • Scratches
    • Warpage
    • Power
63
Q

S.O.A.P.

A
  • Subjective Findings
  • Objective Findings
  • Action: Corrective Action
    • Refer for medical treatment
    • Change lens parameters or material
    • Lens care
    • Wearing schedule
  • Patient instructions