Unit 2

Question 1

Assess Patient Suitability

Answer 1

• Expectations
• Hobbies
• Work Environment
• Medical History
• Ocular History
• Wearing History

Question 2

• Patient history is critical in determining???

Answer 2

◦ Whether a patient is suitable for contact lens wear
◦ To aid in selection
◦ To inform on management

Question 3

Expectations

Answer 3

◦ Motivation for contact lenses
How he/she intends to use the lenses
◦ Expected wear time
◦ Replacement frequencies
◦ Expected visual outcome; most important for presbyopic patients
◦ Fitting process
Time involved
◦ Costs
Fitting, lenses

Question 4

• Hobbies

Answer 4

◦ Discuss any hobbies or sports during which the patient intends to wear the lenses
Soft, hybrid, and scleral rigid lenses are less likely to become dislodged
Swimming is not recommended
–If necessary, a daily disposable lens with immediate replacement
◦ Eye protection, goggles, or safety glasses are still required ◦

Question 5

• Work Environment

Answer 5

◦ Long-term computer use
◦ Dust and debris Esp. for RGPs
◦ Chemical fumes
◦ Safety glasses are still required

Question 6

• Medical History

Answer 6

◦ Conditions and medications can change tear chemistry
Allergies
Pregnancy, menopause
Thyroid
Hyperthyroid- eyes are protruding more
Hypothyroid
–Eyelid position
Autoimmune diseases
–Inflammation
Dermatological conditions (seborrheic dermatitis, atopic eczema, acne rosacea)
Patient’s own physical capabilities
Diabetes
–Prone to infection and poor healing
–Reduced corneal sensitivity

Question 7

Medications

Answer 7

Antihistamines, decongestants
Acne medications
Diuretics
OCP, Hormone replacement therapies
Anti-anxiety/depressants
Beta blockers
Chemo

Question 8

• Ocular History

Answer 8

◦ Last eye exam
◦ Previous ocular surgery or trauma
Esp. refractive surgery
◦ History of ocular infection
◦ Visual acuity
◦ HVID
◦ Refraction
Astigmatism
High myopia
Presbyopia ◦ Keratometry
◦ Topograpy; a map of the cornea (any irregularities/steepness)
◦ Slit lamp; lids, lashes, conjunctiva etc..

Question 9

• Wearing History

Answer 9

◦ Satisfaction
◦ Current lens parameters
Brand / type of lens worn (beware of poor recall!)
◦ Wear schedule
Average daily wear time (hours per day, days per week)
Sleeping in lenses
◦ Replacement frequency
◦ Care regimen

Question 10

Advantages of CL

Answer 10

-Field of view- plus vs minus lens characteristics
-Better for anisometropia- Different prescription in each eye; image size difference issue with glasses
-Stays in place, don’t have to keep adjusting
-improves your side vision because of how it fits perfectly in your eyes
-No glare
-Wider field of view (frames are no longer in field of vision)
-Sports
-Weather
-Irregular cornea
-Less convergence for hyperopes at near
-No prismatic effect

Question 11

Disadvantage of CL

Answer 11

-Fitting time and adaptation
-Lens handling skills
-Risk of infection
-Outdoor or office environment
-Unable to current some BV (binocular vision) problems
-Greater convergence by myopes at near
-Expensive
-Limited UV protection and tints