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CLs > 1 - indications for CL use > Flashcards

1 - indications for CL use Flashcards

1
Q

What are the types of Cls

A
  1. Rigid
  2. Soft
  3. Hybrids
  4. Silicone rubber
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2
Q

What are the materials of RGP

A
  • PMMA
  • Gas permeable materials
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3
Q

What is the size of RGP lenses

A

Smaller than corneal diameter (9.5mm)

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4
Q

What are the materials of SCLs

A

1) hydrogel
- hydrophillic (different water contents)

2) silicone hydrogels
- high oxygen (EW)
-mixture of silicone rubber and hydrophllic material

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5
Q

What is the size of SCLs

A

Larger than corneal diamter (14mm)

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5
Q

What is the size of SCLs

A

Larger than corneal diamter (14mm)

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6
Q

What are refractive indications of CL wear

A
  • myopia (control, improved acuity, greater FOV)
  • hyperopia (possibility of reduced acuity)
    -astigmatism (if DC < DS, possibility of reduced acuity)
  • anisometropia
  • BV problems
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7
Q

What are pathological indications of CL wear

A
  • cranio -facial abnormalities
  • allergies (specs - metal/rubber)
  • irregular cornea
  • keratoconus
  • bandage
  • protection
  • cosmetic
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8
Q

what are some contra-indications

A
  • occupational: - dust/chemical vapours/PC use/ poor ventilation
  • allergies
  • poor hygiene (conjunctivitis, bleph, smoker, herpes zoster)
  • ill health (implications on tear film quality - DM, h-thyroidism/arthirits/menopause)
  • age? ability to handle CLs (infant, student, presbyope)
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9
Q

RGP - why choose?

A
  • Vision (amazing)
  • corneal irregularity
  • handling
  • dry eyes (refit)
  • compliance (less chance of infection)
  • SCL failure
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10
Q

SCL - why choose?

A
  • comfort
  • infrequent wear
  • environment
  • RGP failure incl. fitting problems
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11
Q

When is slit lamp used in CL practice

A
  • CL fitting (baseline measurements)
  • Aftercare (lens fit, surface condition, ocular integrity)
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12
Q

When would you use low mag (6-10x)

A

General eye
- lids/lashes
- cornea
- conjunctiva
- sclera

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13
Q

When would you use medium mag 16x

A

to view structures
- blepharitis
- MGD
- concretions

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14
Q

When would you use high mag (25-40)

A

details (of cornea)
- epithelial changes
- stromal striae + folds
- endothelial folds/blebs ( caused by corneal oedema - lack of oxygen)

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15
Q

When do you see striae in the stroma

A
  • more corneal swelling
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16
Q

what does it mean when you see folds

A

-more than 10% corneal swelling - dangerous

17
Q

why use cobalt blue feature

A

excites fluoroscein dye

18
Q

green (red-free filter)

A

enhance contrast of blood vessels

19
Q

neutral density filter

A

reduces beam brightness
- increases px comfort

20
Q

wratten filter

A
  • enhances NaFI staining when used with blue light (and MAX illuminiation)
21
Q

what does fluoroscien do

A
  • highlights epithelial defects as stains areas of missing cells
  • dye may disappear after 2-4 mins
  • use cobalt blue filter at high illumination
22
Q

pics of staining

A
23
Q

When is specular reflection used

A

to assess tear film and endothelium (high mag)

24
Q

what is retro illumination

A

back light from iris or fundus

25
Q

what can be viewed with from retro illumination

A
  • vacuoles
  • microcysts
26
Q

what is the genersl SL routine

A

start with white light
- general look at ocular adnexea
- diffuse, low mag, whole eye
- sclerotic scatter, low mag

increase mag, parallelpipied
- lashes, lid margins
- tear prism height
- conjunctiva + cornea

change to optic section on high mag to assess depth of anything unusual
investigate limbus separately

27
Q

after general view on slit lamp?

A

use blue light and NaFi
- staining
- conjunctiva
- cornea - location
- TBUT
- LID MARGIN`

28
Q

AFTER BLUE LIGHT

A
  • lower and upper lid eversion
  • meiboiam glands
29
Q

SL when lens is in the eye?

A

Lens fit + conditions

  • diffuse, direct/ indirect for centration and movement
  • direcr for fit + surface condition
30
Q

what are the 2 grading scales

A
  • CCLRU
  • Efron grading scale
31
Q

CCLRU grading scale features, what are adv and disadv

A

real pics - advantage
- grade 1 -4

disadvantages
1) different eyes
2) different illuminations

32
Q

efron grading scale features (adv and disadv)

A

pictoral - disadvantages
- grade 0-4

advantage:
- precise severity shown
- image cosnsistency

33
Q

when grading we grade to the nearest?

A

0.5

34
Q

grade 2 or less is considered …..

A

normal limits

35
Q

what grade change is considered clinically significant

A

more than 1 grade

36
Q

importance of record keeping

A
  • monitering progression
  • record across time
  • px communication
37
Q

principles of grading scales

A
38
Q

when to check corneal staining

A

before and after fitting

39
Q

types of corneal staining (pic)

A

CLs (2 decks)

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