22 23 diet 2 Notes Flashcards
(19 cards)
Smile staining
“SMILE” staining is a contact lens complication primarily caused by hypoxia (lack of oxygen) due to prolonged wear of lenses, particularly extended wear soft lenses. It leads to changes in the corneal epithelium, resulting in small, localized areas of staining. The condition is often exacerbated by poor lens hygiene, inadequate lens replacement schedules, or wearing lenses for longer periods than recommended.
Smile staining clinical signs
Localised corneal staining - small, irregularly shaped epitlelial defects, often at the central or inferior cornea .
Fluroscein staining - positive fluroscein staining durring slit lamp examination showing areas of disruption in the corneal epithelium
Smile symtoms
discomfort ot irritation - px may report forign body sensation or mild irritation due to epithelial defects
blurred vision - px may experience slight visual disturbance caused by the irregular corneal surface.
Smile managemnt
discontinue lens wear
switch to a diff lens type
improve lrns hygiene
prescribe lubricants
Recording appearance and fitting characteristics of a toric lens
RE (aligned)
- lens fit - the RE lens is fitttng with minimal movement, showing amn aligned fit.
- toric marking - the toric marking of the lens shoulf be located within 5 deg of the correct position
LE (flat fit)
- lens fit - lens is flat with more then 20 deg of toric marking rotations
- toric marking - the toric marking is rotated 30 degrees temporally from the ideal position, indicating a misalignment
Risk factors associated with extended wear contact lenses
Hypoxia - limites oxygen supply to the cornea, which may cause corneal oedema, reduced epi healing anf long term damage.
Infection - prolonged wear increase the risk of bacterial, fungal or viral infection, particaularly when hygene is poor.
Extended wear lenses example
acuvue oasys astig by J&J, up to 6 nights and 7 days of extedned wear
Risks of contact lens wear in dry eyes and how to minimise impact
Risks -
- reduced comfort
increased risk of infection as tear films ability to protct against pathogens is reduced
- lens displacement
Minimising the impact -
- use of hydrogel lenses
- frequent lubrications
- reduced lens wear time
- perscription adjustments
Monovision principles
fitting one eye for distacne and other for near. compensates for presbyopia by allowing the px to focus at diff distances with each eye
Monovision fitting procedure
- normal pre fit exam
- lens selection - choose appropriate c lens for each eye, typically near correction in non -dom eye.
- trail and adjustment - use of trail lenses to allow px to see fit of lens and experience vision in each eye.
Advantages and disadvantages of monivision
Advantages:-
- convenienve
- cost effective
- improved depth perfeption
Disadvantages:-
- reduced visual clarity
- adaptation period
- BV issues
Questions to ask new Cls px
- have you ever wore lenses in the past
- what are you inetending to use lenses for
- are you wanting lenses that you dispose at the end of the day or is cleaning not a issue
- how may hours per day do you intend to wear the lenses
- do u have any eye conditions or dry eye
- how is you current vision with specs
- if months, are you okay with cleaning lenses at night.
factors to consider when deciding recall
- lens type adn wear scedule
- px ocular health
- age
4.compliance - lifestyle and occupation
features of lens surface to assess on aftercare
deposits on lens surface (protein, lipid or calcium)
scrathces or damage
surface wettability
Importance of using grading scale
objective assesment
monitoring and documenting
steps to cleaning and removing SCL
- hygiene and prep
- removal of scl (like you teach in INR)
- cleaning
Additives in multipurpose solutiion
Surfacants
disinfectants
hydrators
buffer agents
How to assess compliance at an after care appt
areas to cover
- General history and wear habits
- lens care practices
- ocular health and lens fit assesment
- concluding by asking goof reinfoecement
