unit 8 Flashcards
Contact lens solution options
◦ Multipurpose solution
◦ Hydrogen peroxide solution
◦ Additional cleaners
◦ Additional drops
Protein removers Artificial tears
Initial Visit
◦ Trial lens fitting
Fit and visual acuity
◦ Insertion & removal training
◦ Solution education
◦ Wearing time instructions
◦ Book follow up appointment
◦ Wear contact lenses to follow up appointment
Follow-Up Care
- Necessary to monitor for adaptation
- Minimize possible CL-related complications
- Typical follow-up schedule:
◦ 1-2 week follow-up
◦ 1-month follow-up
◦ Annual eye exam thereafter
Follow Up Visit
Arrive wearing contact lenses
* Questions to ask
◦ Any problems, issues, or concerns
◦ Maximum wearing time (Max WT)
◦ Wearing time today (WTT)
◦ Comfort
◦ Vision
* Assessment
◦ Visual acuity must do first before slit lamp
◦ CL assessment (fit, movement, lens quality)
◦ Remove CL
◦ Corneal staining
Refit if needed
◦ Trial of new parameters or brand
◦ Send home with new trials
◦ Book follow up appointment
Current Contact Lens Wearer
Arrive for exam with contact lenses in eyes
* Capture CL info with case history
◦ Confirm contact lens parameters
◦ Wearing schedule (days/week)
◦ Max WT and WTT – Extended wear?
◦ Replacement frequency
◦ Age of current CL
◦ Solution (and how they utilize it)
◦ Comfort and vision
* Slit lamp assessment
◦ Fit, movement, lens quality
◦ Corneal staining, GPC
Ocular health concerns- Absolute contraindications
Corneal infections, viral/bacterial conjunctivitis, severe ocular allergies that cannot be improved with medication, having to use ocular medication throughout the day, severe GPC, ocular inflammation
Potential contraindications
Ocular allergies, dry eyes, GPC, corneal dystrophies, keratoconus,
irregular astigmatism, corneal scarring
Overnight wear
◦ Dk/t of lens
◦ Silicone hydrogel material
◦ Corneal neovascularization
Contact lens associated health concerns
GPC, corneal staining, dry eye, corneal neovascularization, corneal edema (swelling), contact lens deposits (proteins or lipids)
CL wearing scheudle for new patient
◦ Start with 2 hours on first day
◦ Increase by 1-2 hours/day
◦ Maximum of 10 hours/day before follow up
◦ Arrive for follow up with contact lenses in eyes
CL wearing scheudle for experinced patient
◦ Maximum of 14 hours/day
◦ Glasses are necessary for backup and days off
Soft CL care systems
◦ Estimated risk of CL-associated infection is 60 times greater in a CL wearer vs a non-lens wearer
◦ CL prevents clearance of microorganisms from the ocular surface
◦ Risk is significantly increased in wearers who: Don’t regularly disinfect their CLs
Don’t properly use the storage case
Don’t wash their hands
- Hygiene regimen
◦ ‘Rubbing and rinsing’ is more effective in removing microbes than rinsing alone
Removes loosely bound deposits on lenses
Reduces levels of microorganisms on the lenses
The Evolution of Soft Lens Care Systems
◦ Historically, was complex and time-consuming
Heat (1972)
◦ Changed with the introduction of multipurpose solutions (MPS)
Majority of soft CL wearers are prescribed MPS Remaining use peroxide based care system
Acuvue RevitaLens
- Johnson & Johnson Vision Care
- Multipurpose disinfecting solution
◦ Rub for 2-4 seconds
◦ Rinse for 5 seconds
◦ Soak for 6 hours - Preservative ingredients
◦ Alexidine dihydrochloride ◦ Polyquaternium - Claim to fame
◦ Delivers all day comfort
Biotrue
- Bausch & Lomb
- Multipurpose solution
◦ Rub for 20 seconds
◦ Rinse for 5 seconds
◦ Soak at least 4 hours - Ingredients
◦ Hyaluronan (HA) - Preservative ingredients ◦ Polyquaternium
◦ Polyaminopropyl biguanide - Claim to fame
◦ Works like your eyes
Complete MPS Easy Rub Formula
- Johnson & Johnson Vision Care
- Multipurpose solution
◦ Rub for 10 seconds
◦ Rinse for 5 seconds
◦ Soak for 6 hours - Preservative ingredients ◦ Polyhexamethylene
biguanide - Claim to fame
◦ Reliable disinfect
Optifree Replenish
- Alcon
- Multipurpose solution
◦ Rub for 20 seconds
◦ Rinse for 10 seconds
◦ Soak for 6 hours - Preservative ingredients ◦ Polyquad
◦ Aldox - Claim to fame
◦ Enhanced comfort
Optifree PureMoist
Alcon
* Multipurpose solution
◦ Rub for 20 seconds
◦ Rinse for 10 seconds
◦ Soak for 6 hours
* Ingredients ◦ Hydraglyde
* Preservative ingredients ◦ Polyquad
◦ Aldox
* Claim to fame ◦ All day comfort
Renu Advanced Formula
- Bausch & Lomb
- Multipurpose solution
◦ Rub for 20 seconds
◦ Rinse for 5 seconds
◦ Soak for 4 hours - Preservative ingredients
◦ Polyaminopropyl biguanide
◦ Polyquaternium
◦ Alexidine - Claim to fame
◦ Triple disinfection system
SoloCare Aqua
- Menicon
- Multipurpose solution
◦ Rub for 10 seconds
◦ Rinse for 10 seconds
◦ Soak for 5 minutes - Preservative ingredients
◦ Polyhexamide biguanide
(PHMB) - Claim to fame
◦ MicroBlock case
◦ Clean lenses in 5 minutes
Hydrogen Peroxide
- Broad spectrum efficacy
◦ ‘Gold standard’ in terms of soft contact lens disinfection - Breaks down into oxygen and water ◦ ‘Environmentally friendly’
- Toxic to the eye(!)
◦ Requires neutralization before lens can be worn
◦ Method: A disc is integrated into the storage case that leads to
neutralization
◦ Long-term storage is not advisable
ClearCare
- Alcon
- Hydrogen peroxide
solution - ClearCare vs ClearCare
Plus
◦ HydraGlyde added to
ClearCare Plus - No preservatives
- Warning: HydraGlyde cannot be used with hybrid lenses
Oxysept UltraCare Formula
- Johnson & Johnson Vision Care
- Hydrogen peroxide solution with neutralizing tablet
◦ Use daily cleaner first
◦ Soak for 6 hours - No preservatives
- Warning: may cause
damage with Illusions contact lenses
Saline Solutions
- Helpful to new wearers
◦ Lens handling, more attempts at I&R - Rinsing prior to application
PuriLens Plus
- PuriLens
- Non-preserved saline
- Ingredients
◦ Sodium chloride - Purpose
◦ Rinsing lenses
◦ Use to fill/insert hybrid or
scleral lenses - Claim to fame
◦ Preservative-free
