CL 2-1: Intro to GPs Flashcards Preview

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Flashcards in CL 2-1: Intro to GPs Deck (43):
1

1. GPs: Better Vision than SCL or SRx at Distance/Near?

2. CSF: GPs were best at what?

1. Distance

2. Middle and High Spatial Frequencies (then SCL then Spectacles)

2

O2 to Cornea

1. Why do they provide more O2 than SCL?

1. GPs Move more than SCL, and are less reliant on Material Dk to provide O2 to the Eye

So you get LESS HYPOXIA (neo and corneal edema)

3

Stability and Durability

1. Tearing?

2. How often are they replaced?

3. Deposits on the Lens?

1. None

2. usually every year or prn

3. No. LESS. (Smooth finish and lack of Water Retention = they harbor fewer deposits)

*More stability/durability means better value for patients while still maintaining a high profit margin.

4

1. 3 Main types of IRREGULAR ASTIGMATISM GPs can correct?

1. Corneal Scarring

2. Keratoconus

3. Pellucid Marginal Degeneration

5

Corneal Reshaping (Ortho-K)

1. Lenses create pressure on the cornea: what does this do?

2. Goal for vision is to stay clear enough throughout the day so lenses are only needed when?

1. Compresses the Epithelial Cells Indirectly
a. MYOPIA: CENTRAL Flattening
b. Hyperopia: PARACENTRAL Flattening w/relative Central Steepening

2. At Night

6

Why are CLs better than GPs? (3)

1. Pt looks thru Optical Center more often

2. Less Chromatic/Spherical Aberration

3. Elimination of Prismatic Effect

7

GP Comfort

1. Lens Awareness: Driven mostly by what?
a. Lens awareness is not as much due to what?

1. By the EYELID Sliding over the edge of the CL

a. Not as much due to CORNEAL Sensation

8

Language

1. What 3 things shouldn't be said?

2. What should the patient say?

1. Rigid Lenses; Hard Lenses; Rigid Gas-permeable CLs (RGPs)

2. Gas-Permeable CLs (GPs)!!!

9

Patient Presentation

1. Terms to Avoid (what should be used)

a. Hurt

b. Pain

c. Discomfort

d. Irritation

e. Uncomfortable

1. a. Initial Sensation

b. Edge Awareness

c. Lid Sensation

d. Itching

e. Lid Awareness

10

4 Pros of Using Anesthetic during the fitting

1. Greater Pt satisfaction

2. Improved Initial Comfort

3. Less Initial Chair time

4. Less Reflex Tearing

11

4 Cons of using Anesthetic during the fitting (DEMS)

1. Does not help w/lid sensation

2. Eye Rubbing

3. Misleading

4. Staining

12

Assessing GP Candidacy

1. Good GP Candidates (5)

1. Current/previous GP wearer

2. Failed SCL wearer (depends on reason)

3. Pts prone to SCL complications (GPC; Inflammation/infection; SEAL)

4. Pts desiring sharper vision

5. Pts w/Astigmatism

13

Pre-Fit Exam

1. BCVA: Special consideration needed if BCVA is what?

2. Good Refraction: Why is this needed?

3. What determines INITIAL diagnostic GP?

1. is reduced in 1 eye or both (INFORMED CONSENT)

2. Reduces fitting time; and Enhances Results

3. K-Values

14

K-Values

1. If Cornea is TOO STEEP: What do you do?

2. If TOO FLAT, what do you do?

1. Put in a +1.25 D on Obj side of Keratometer, then Approximate by ADDING +8.00 D to reading

2. Use -1.00 D lens, and SUBTRACT -6.00 D from reading

15

Persistently Irregular Mires indicate Irregular Astigmatism. (what 4 are the main ones?)

1. Corneal Scarring

2. Corneal Dystrophies

3. Keratoconus

4. Pellucid Marginal Degeneration

16

Upper Lid Position

1. Above upper limbus

2. At Upper limbus

3. Below upper limbus

1. Interpalpebral (Smaller Diameters)

2. Interpalpebral (Smaller diameters)

3. Lid Attachment

17

Vertical Palpebral Aperture

1. Why would Smaller Palpebral Apertures may Benefit from GP CLs?

1. cuz they're usually smaller than SCLs (8.0-10.00 mm vs. 14-15 mm)

18

Eyelid Tension

1. Affects what 3 things?

1. Lens positioning, GP removal, and Near Vision in Translating (mainly affected by upper lid tension) Multifocal GPs

19

2 Bottle Cleaning Systems

1. 4 of them. What are they?

1. Boston Original

2. Boston Advance Comfort

3. Menicare GP

4. Optimum by Lobob

20

2 Bottle Cleaning Systems: Boston Original

1. Type of Cleaner?

2. Conditioner: Has what 2 Preservatives?

3. Compatible w/what?

Cleaning

4. Remove lenses when?

5. Clean w/what cleaner?

6. Rinse with what?

7. Soak in what? (Min Soak?)

8. Then what?

1. Abrasive cleaner

2. Chlorhexidine, and EDTA

3. Weekly Boston 1-Step Liquid Enzyme

4. At Night

5. with Red CAPPED cleaner

6. Saline

7. BLUE CAPPED Conditioner overnight (MIN 4 Hrs)

8. Insert Lenses in the morning

21

Purpose of Cleaner

1. Remove foreign Material (what 3 things)

2. Remove Cellular Debris (what 3 things)

1. Lipid, Mucus, Protein

2. Tear Film constituents, Environmental Debris, and Contaminants from Pts Hands

22

Purpose of Conditioner

1. Cushioning Properties are DIRECTLY related to what?

2. Best cushioning solutions provide cushioning w/o affecting what?

3. Acts as what kind of buffer? Between what 2 things?

1. to VISCOSITY

2. Vision or being too "goopy"

3. Mechanical Buffer; B/W Cornea and Lens

23

2 Bottle Cleaning System: Boston Advance Comfort

1. Type of Cleaner

2. Conditioner: What 3 things?

3. Compatible with what?

4. Remove lenses when?

5. Clean with what?

6. Rinse with what?

7. Soak in what?

8. Insert Lenses in what?

1. Abrasive

2. Chlorhexidine, EDTA, PHMB

3. with Weekly Boston 1-Step Liquid Enzyme

4. at Night

5. with RED CAPPED Cleaner

6. SALINE

7. BLUE CAPPED conditioner (min 4 hrs)

8. in the morning

24

2 Bottle: Optimum (Lobob)

1. CDS: What is it?

2. ESC: What is it?

3. WRW: What is it?

4. Preserved with what?

5. Remove lenses when?

6. Clean with what solution?

7. Rinse in what?

8. Soak in what? (Min hrs?)

9. Rinse with what?

10. Apply what?

11. Insert lenses when?

1. Cleaning, Disinfecting and Storage Solution

2. Extra Strength Cleaner

3. Wetting ReWetting Drops

4. with Purified Benzyl Alcohol

5. at Night

6. RED CAPPED CDS

7. SALINE

8. RED CAPPED CDS overnight (min 6 Hrs)

9. SALINE

10. WHITE CAPPED WRW

11. in the morning

25

2 Bottle Cleaning Systems: Optimum "2 Bottle System)

1. 2 Bottles used for routine care?

2. Third Bottle: What is it?
a. May be used when?

1. CDS, WRW

2. ESC: Only used for STUBBORN DEPOSITS

a. PRN

26

2 Bottle Cleaning Systems: Menicare GP (Menicon)

1. What 2 bottles?

2. Preserved with what?

3. Formulated for use with what materials?

1. CDS; WRW

2. with Benzyl Alcohol 0.3% and Disodium Edetate 0.5%

3. with Menicon Materials

27

2 Bottle Cleaning Systems: Menicare GP (2)

1. Remove Lenses when?

2. Clean with what?

3. RINSE with?

4. Soak in what?

5. Rinse?

6. Apply with what?

7. Insert lenses when?

1. at night

2. RED CAPPED CDS

3. SALINE

4. RED CAPPED CDS overnight (min 6 hrs)

5. with SALINE

6. with WHITE CAPPED WRW

7. in the Morning

28

1 Bottle Systems

1. What 2 are they?

1. Boston Simplus

2. Unique pH

29

1 Bottle Systems: Boston Simplus

1. Single bottle (cleaning/rinsing/soaking): Type of Cleaner?

2. Preservatives?

3. Remove lenses when?

4. Soak in what? (min)

5. In the morning, clean and rinse lenses with what?

6. then insert lenses.

1. Non-Abrasive

2. Chlorhexidine

3. at night

4. WHITE CAPPED SIMPLUS overnight (min 4 hrs)

5. with WHITE CAPPED SIMPLUS

30

1 Bottle Systems: Unique pH (Menicon)

1. Cleaner type?

2. Preservatives?

3. Clean and rinse lenses with what?

4. Soak in what?

1. Non-Abrasive

2. EDTA, Polyquad

3. WHITE CAPPED Unique pH

4. White Capped Unique pH overnight (min 4 hrs)

*insert lenses in the morning

31

Oxidative Lens System: Clear Care (Alcon)

1. Approved for what?

2. Preservatives?

3. Great for what?

4. Remove lenses at night, and RINSE with what?

5. Soak in what?

6. In the morning, do what?

1. GP lenses too!

2. None

3. Piggyback Systems (use 2 cases)

4. RUB and Rinse lenses w/RED CAPPED CLEAR CARE

5. in RED CAPPED CLEAR CARE overnight (min 6 hrs)

6. Insert Lenses

32

Things NOT to use as Cleaners

1. WILL LIKELY NOT DAMAGE LENSES: (4)

2. WILL DAMAGE LENSES (5)

3. Which ones will impact surface wetting?

1. a. Coke
b. Dishwashing Soap
c. Laundry Detergent
d. Shampoo

2. a. Acetone
b. Alcohol
c. Gasoline
d. Kerosene
e. Lighter Fluid

3. Any/All of these products

33

Lab: In-Office Cleaners

1. Boston Laboratory Cleaner: What is it?

2. Fluoro-Solve (Paragon): Type of Solvent?

a. What 6 things...??

1. Isopropyl Alcohol

2. Wax Solvent

a. Adhesive Tape residue; Body Oils, Cosmetics, Deposits, Pitch; Waxy Build-up

34

Enzymatic Cleaners

1. What do they HYDROLYZE?

2. Required more often with what type of lenses?

1. PROTEIN

2. with SILICONE ACRYLATE (SA) LENSES than Fluorosilicone Acrylate (FSA) lenses

35

Periodic Enzymatic Cleaners

1. Opti-Free Supra-Clens Daily Protein Remover (Alcon)
a. What Enzyme is in it?
b. 1 Drop in each lens well when?
c. Does it have to be rinsed off before lens insertion?

2. Boston 1-step Liquid Enzyme
a. Enzyme?
b. Come as what kind of drop?
c. Used when?
d. Number of drops in lens well when soaking overnight?
e. Does it have to be rinsed off before lens insertion?

3. What other thing?

1. a. Pancreatin
b. NIGHTLY
c. YES!

2. a. Subtilisin
b. Single-use VIALS
c. WEEKLY
d. 2 DROPS
e. YES!

3. Progent (Menicon)

36

Oxidative Lens System: Progent (Menicon)

1. In office GP "Super Cleaner": Why?

2. Ampule A

3. Ampule B
a. What do you do?

4. Efficacy of Protein Removal from GP surface after 30 min soak
a. Artifically protein-deposited lens
b. Actual patient's protein-deposited lens

5. Now available in what?
a. Recommended every what?

1. Removes protein, Kills (bacteria, Viruses, acanthamoeba, yeast, mold); Deactivates Bovine Rotavirus, HSV I, and Adenovirus 5

2. Sodium Hypochlorite

3. Potassium Bromide

a. Mix and Swirl and 30 min soak.

4. a. Almost everything gone

b. Doesn't do too much.

5. w/Saline Vials for Pt Home Use

a. every 2 WEEKS

37

GP Rewetting Drops

1. GP Only: What 3 are there?

2. SCL and GP: What three things?

1. a. Boston Rewetting Drops (B & L)

b. Optimum WRW

c. Menicare GP WRW

2. a. Blink Contacts (AMO)

b. Opti-Free Express, RepleniSH or Puremoist Rewetting Drops (Alcon)

c. Theratears CL Comfort (Advanced Vision Research)

38

Short-Term Lens Storage

1. WET
a. Patients store lenses how?

b. Soaking helps do what?

c. Preservatives help to control what?

1. a. WET overnight

b. Dissolve Hardened Deposits

c. Microbes

39

Long-term Lens Storage

1. DRY
a. Lenses should be what before storage?

b. What is the risk if you store Lenses Wet?

c. Clean lenses thoroughly Prior to what?

1. a. Completely DRIED

b. You RISK WARPAGE

c. to Dry Storage. Pseudomonas and Strep can still grow on Dry Lenses

40

Use of Tap Water

1. Why is it Controversial?

1. Association w/Acanthamoeba Keratitis

Bennet and Henry: State that TAP WATER is CI in all CL care regimens including GP

When educating PATIENTS, SALINE is the SAFEST RINSING RECOMMENDATION

41

In-Office GP Disinfection

1. What do you do?

2. What if you are using a Diagnostic Lens: What do you do afterwards?

1. Clean, Rinse, Condition Lens BEFORE putting GP in Pt's EYE

2. Soak lens in case in OXIDATIVE SOLUTION for 10 MINUTES; Rinse and Clean w/SALINE; Dry lens and Case with Paper TOWEL, then STORE DRY

42

Removal of GPs: 2 Hand Method

1. What is it?

1. Pt look down --> lift upper lid w/non dominant hand --> Instruct Pt to look straight ahead --> use index finger of dominant hand to depress lower lid BELOW the CL Edge --> Slowly bring upper and lower lids together until the lens is ejected. Lens may hang from lower lashes --> have pt close their eyes then remove lens

43

What else can be used for GP removal?

1. DMV

*It's pretty simple. Clean DMB by washing is frequently in warm, soapy water. May Boil or Autoclave if you want.