Week 5 - Complications

Question 1

What are some indications for CL wear? 5

Answer 1

-Medically Necessary Contact Lenses
-Professional reasons
-Anisometrope
-Young children with high Rx.
-Severe dry eyes

Question 2

Contact lenses are the preferred way to correct RX with over 3D difference or + in one eye and - in the other. Why?

Answer 2

as it has minimal impact on image size

Question 3

What are some contraindications to CL wear? 3

Answer 3

-Non compliant patients
-Recurrent infections
-Professional reasons (fume workers)

Question 4

What is over-refraction?

Answer 4

technique used to show effectiveness of the cls and fine tune the prescription

Question 5

How do we correct Unanticipated lacrimal lens
formations? 2

Answer 5

Change the fit or Rx

Question 6

How do we correct lens rotation?

Answer 6

Change the Rx (axis)

Question 7

How do we correct changes in refractive error?

Answer 7

Change the Rx (i.e refer to optometrist)

Question 8

How do we correct lens warpage?

Answer 8

Dispense new lens and retrain

Question 9

How do we correct lens flexure?

Answer 9

Remake lens with thicker CT

Question 10

How can we detect Lens flexure?

Answer 10

by checking the K’s when patient is wearing the lens.

Question 11

What two conditions can indict that there is lens flexure?

Answer 11

-unexpected cylinder
-the lens is warped

Question 12

The patient comes in with Bilateral SPK or mild irritation at a 1 month follow up.

What could have caused this issue? 2

Answer 12

deposits on the lens
solution sensitivity

Question 13

If you notice a px has Bilateral SPK or mild irritation what should do? 2

Answer 13

-discontinue lens wear for 2 days
-then switch to a different MPS or Clear Care.

Question 14

If a px has Bilateral SPK or mild irritation and wears RGP lenses what should we do?

Answer 14

likely to be using Boston Simplus so have patient rinse the lens with saline prior to insertion.

Question 15

If a px is having Difficulties removing lenses what could be causing it?

Answer 15

px could be showering in lenses which causing tightening of lens (remind not to shower)

Question 16

If a px is having Difficulties removing lenses what can we reccommend?

Answer 16

Instill Artificial tears and closed eyes for 1 min prior to removing
lenses.

Question 17

If a px is experiencing discomfort in the afternoon from cl what should we do? 2

Answer 17

• switch to clear care/ prescribe artifical tears
  -instill drops prophylactic to help (before its too dry)

Question 17

What is the likely cause of eye discomfort in the afternoon?

Answer 17

dry eyes

Question 18

If a patient has used clear care directly on the eye or without waiting for the lens to neutralize what should we reccommend? 3

Answer 18

• Rinse eye with Saline, preferably preservative free.
• Instill preservative free artificial tears every hour until better
  -refer if doesnt get better or too severe

Question 19

If a px presents with solution sensitvity, what can we do? 2

Answer 19

-use saline solution with MPS/hydrogen peroxide solutions
-thicker eye drops

Question 20

Why does a new rigid lens wearers present with partial blinks or a narrowing of their palpebral aperture?

Answer 20

it is an attempt to decrease lid
sensations.

Question 21

Why does a new rigid cl wearer aquire induced true acquired
non-senile blepharoptosis (dropping of upper eye lid)? 2

Answer 21

-mechanical manipulation of the
eyelids,
-mild contact-lens-induced lid inflammation

Question 22

If a px develops Protein deposit formation on the lens, what can we suggest? 3

Answer 22

-lens replacement frequency needs to be
increased
-have the lens polished
-use protein removing agents such
as Progent or One Step

Question 23

If the rigid lenses are non-wetting (detected on slit lamp) what might the patient experience or report ? 3

Answer 23

-discomfort
-hazy vision
-the frequent need for lens removal and
cleaning.