Week 1 - CL preliminary examination Flashcards
What type of Px may appear?
• New CL wearer
• Existing CL wearer
• Lapsed CL wearer
• Previously tried and failed to wear CL
• Px with problem/recall letter
What questions from a standard H&S are kept?
• History of Flashes/floaters/diplopia/headaches
• Family general health
• Family ocular health
What questions to we add?
• Allergies
• Specific meds that can cause dry eye
• History of dry eye/red eye/infections
• Any previous CL wear
Why do you want to try lenses?
• Are you looking for FT/PT/EW?
• Would you be happy cleaning and looking after lenses?
What questions do we ask an existing CL wearer? (new to you)
• Do you know the name of the lens you are wearing?
• Name of solution (if applicable)?
• How do you clean and store your lenses (if applicable)?
•How long have you been wearing lenses?
• How often do you wear your lenses?
• Do you sleep in your lenses?
• Have you ever had any problems with your lenses?
• Any infections?
• When was your last aftercare? (and sight test)
•Are you happy with these lenses?
What questions do you ask a lapsed CL wearer?
Need to find out what went wrong + best solution
• Why did you stop wearing lenses?
• When did you stop wearing your lenses?
• Do you know the name of the lens you were wearing?
• How long did you wear lenses for?
• How often did you wear your lenses?
What are some reasons why a px may have previously tried and failed with CLs?
Why?
• Squeamish about lenses
• Couldn’t manage I&R
• Cost
• Comfort
• Vision not satisfactory
What changes to H&S would you make to who previously tried and failed with CLS?
• Why did you stop your CL trial?
• Do you know the name of the lens you tried?
• How long did you try the lenses for?
What are some examples if common meds that may cause dry eye? (6 total)
- Beta blockers
- Anti-histamines
- Contraceptive pill
- Acne medication
- Anti-depressants
- HRT
How are patient expectations managed?
• Possible vision can be worse with CLs due to movement, and tear quality
• With children, make sure the CHILD wants the contact lenses
What are the two types of keratometer?
- Javal-Schiotz (2-position)
- Bausch & Lomb (1-position)
How are K’s value recorded?
Example: 7.90@90
7.85@180
• Can you estimate the cyl from the K’s?
How?
- Approx 0.25DC for every 0.05mm
What are some important notes on the Javal-Schiotz
• Axis read 90° away from curvature
• Think along which axis the mires are moving, and wont go wrong
What are HVID/VVID?
•Horizontal visible Iris diamater
•Vertical visible Iris diameter
- All measured with ruler
• Done to determine approx lens size
Why do we need to know pupil size?
Why do we need to know this?
- To help with choosing lens design
- Especially in RGP fitting
• Why do we measure in photopic/scotopic conditions?
- pupil sizes change
How is pupil sized measured in the dark?
• Use of UV light doesn’t constrict pupil
• Therefore a UV lamp (Burton lamp) is used with ruler
