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CL_Test2 Flashcards

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1
Q

Name good candidates for GP Lens

A
  1. Ks and manifest predict good vision
  2. WTR corneal astigmatism is better
  3. Small to mod pupilsize.
  4. FTW
  5. Critical observers due to improved vision
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2
Q

T/F

OZD is larger in GP lens compared to spherical lens

A

False

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3
Q

Name the two benefits in fitting GP lens diagnostically

A
  1. Higher initial success

2. Fewer re-orders

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4
Q

Name some paramaters for selecting lens diameter on GP lens

A

OAD: avg is 9.20-9.50mm
OZD: avg is 7.80 - 8.40mm
HVID-2.3mm
Consider lid aperture size and/or pupil size

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5
Q

What is the trend in fitting flat and steep corneas with GP lens?

A

Flat, hyperopic corneas = Fit with larger OAD

Steep, myopic corneas = Fit was smaller OAD

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6
Q

Name two practical applications for the use of burton lamp

A

Viewing:

  1. Kids
  2. Obese pts
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7
Q

What is a big disadvantage to the usage of anesthetic when fitting GP lens?

A

It does not allow doctor to observe the freak out factor

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8
Q

Name the three fitting philosophies

A
  1. Lid attachment
  2. Interpalpebral
  3. Modified lid attachment
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9
Q

Describe central clearance or central cooling/

Apical clearance or apical pooling

A

The lens is fit STK

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10
Q

Describe central bearing or central touch;

Apical bearing or apical touch

A

The lens is fit FTK

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11
Q

Describe central alignment

A

Minimal apical clearance MAC.

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12
Q

How do you describe the mid-periphery patterns?

A

Clearance
Bearing(touch)
Alignment

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13
Q

How do you describe peripheral clearance(aka pooling, edge lift)?

A

Minimal/inadequate
Moderate/Medium
High/Excessive

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14
Q

What do you need to consider if your over-refraction is greater than or equal to 4.00D?

A

VERTEX DISTANCE

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15
Q

What is the minimum information needed for RGP ordeirng

A 
OAD
BCR
Power
Material
Color
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16
Q

What is and what does it stand for:

F-S/A

A

Fluoro-Silicone Acrylate
It is a type of material
Categorized in low D/k and high D/k

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17
Q

GO through the summary of Diagnostic Fitting GP - steps:

A
  1. Select lens diameter
  2. Select BCR (initial)
  3. Evaluation
  4. Perform Spherical Over-refraction
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18
Q

Look over BENNETT BASE CURVE RADIUS

A

Spherical to low cyl: FTK
Mod cyl: On K
High Cyl: STK

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19
Q

What are the components in evaluating a lens fit?

A
  1. Fitting philosophy
  2. Lens position
  3. NaFl Pattern
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20
Q

What is the common power of Diangostic lenses

A

-3.00D

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21
Q

What is another term for Peripheral Curve Radius (PCR)

A

Tertiary Curve Radius

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22
Q

What happens if you steepen the BCR

A

You get a positive tear lens and SAM

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23
Q

What does SAM stand for

A

Steeper add Minus

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24
Q

T/F

0.10mm increment change to BCR; change the power by 0.50D

A

True.
THis is an approximation
Use conversion chart or convert mm to D to be exact

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25
In what increments do you modify BCR
0.10mm increments | The smallest that can be made is: .05
26
Manipulating BCR parameters: | Flattening vs Steepeining?
Flatter BCR to loosen the fit(Increase in mm, decrease in D) | Steepen BCR to tighten the fit
27
In what increments do you modify OAD
0.50 increments | Smallest change: 0.30 smallest sig change
28
Which two CLs paramaters operate together
1. OAD | 2. OZD
29
T/F | A larger OAD and/or OZD increases the sag ht?
True
30
How do you maintain the same fitting relationship b/w OZD and BCR
Flatten BCR by 0.05 while increased OZD by 0.50
31
Which two CLs parameters are dependent on pupil size
1. OZD | 2. OAD
32
In what increments do you modify PCR
Modify in 1.0 mm increments | 0.50 smallest significant change
33
In what increments do you modify PCW
Modify in 0.20 increments | Smallest change: 0.10mm
34
Talk about Blend
``` Usually don't specify Anticipate medium Remove debris Loosen fit Eliminate bearing Factor in patient comfort ```
35
Edge: CN bevel and + lenticular are good for.....
High minus Cls that are greater than -5.00D | It makes the thicker edges thinner and more comfy for pt
36
Edge: (-) lenticular are good for....
Low minus, less than 1.50D and plus lenses
37
T/F | Lenses around plano are shaped like a plus lens
True
38
What is the ideal edge fit?
It is smoothly tapered with apex 1/2 to 2/3rds posterior
39
Name some advantages for fitting GP lens
``` Quality of vision Safety-Microbial keratitis is more likely for SCL Long term comfort Ease of care Durability Profitability Patient loyalty ```
40
What are some disads for GP lens
Initial comfort Intermittent wear Dust will mess it up
41
What is the main disadvantage for GP lens
Its initial discomfort | This is the biggest factor
42
How does An increase in oxygen permeability affect wettability?
It decreases wettability. | As u go higher in oxygen permeability, lens stability also decreases
43
T/F | Today, we are not as considered about oxygen permeability and wettability
True.
44
Name the four different types of materials?
Polymethyl methacrylate (PMMA) Cellulose acetate butyrate (CAB) Silicone/Acrylate (S/A) Fluoro-Silicone Acrylate (F-S/A)
45
Downside of polymethyl methacrylate (PMMA)
Low oxygen permeability | Wettability was real good tho
46
Ad and disad of cellulose acetate butyrate (CAB)
Increased oxygen perm Scarates easily Warpage Obsolete
47
Tell me about Polycon II
``` Silicone-Acrylate Dk 12 Manufacturer is Paragon It provides good oxygen permeab compared to predecesors Has good durability ```
48
Tell me about Fluoroperm 30
Material: F-S/A Dk: 30 Manufact: Paragon
49
What is considered low Dk for F-S/A
50 and below
50
What is so special about Menicon Z
Dk = 175 | Sometimes referred to as a hyper Dk lens
51
Name the 5 diff F-S/A
``` Boston XO Paragon HDS 100 Optimum Extra Boston XO2 Menicon Z ```
52
What is SynergEyes
Hybrid lens Dk rigid = 130 Dk Soft skirt = 84. (it gives the rigid lens quality and the soft lens comfort).
53
T/F | Plasma trt is a coating
Nope
54
What does plasma trt do to wettability?
It enhances initial wettability(decreasing the wetting angle)
55
Are most lens designs tri-curves or tetracurves?
Tri-Curves
56
Define Standard geometry
Eye is steeper in the center and it flattens as you go out in the periphery. The opposite occurs in Reverse Geometry.
57
What is the lens called when you get 2 BCR 2 powers 1:1 Ratio (BCR:Power)
SPE bitoric lens
58
What is the lens called when you get 2 BCR 2 powers Ratio is not 1:1 (BCR:Power)
Back Surface toric lens if................. 1:1.5 = PMMA or 1:1.4 (GP)
59
What is the lens called when you get 2 BCR 2 powers Ratio is not 1:1 (BCR:Power)
CPE Bitoric Lens Not 1:1.5 = PMMA or Not 1:1.4 (GP)
60
T/F | For a tricurve lens, the terms "secondary" and "intermediate" can be used interchangeably
True
61
T/F | For a tetracurve lens, the term "secondary" refers to the area immediately outside of the optic zone.
True
62
What does projection system measure
OAD OZD It makes things bigger
63
What does Loupe/V-gauge represent
OAD | OZD(loupe)
64
What does center thickness gauge measure
Center thickness
65
What does keratometer mounted devices measure
BCR
66
What does radiuscope measure
BCR | Center thickness
67
When is the diff b/w BVP and FVP significant?
With (+) lenses
68
What is Drysdale Principle.
BCR - measuring the dist b/w the real img and the aerial img - lens surface and the center of curvature
69
T/F | It is possible to measure SCR and PCR with radiuscope
True | But we rarely do this in clinic.
70
A minus tear lens is associated with which fitting relationship?
Flat
71
A plus tear lens is associated with which fitting relationship?
Steep
72
What does CLIK stand for
Contact Lens Identification Kit. | Only good for identifying PMMA & older RGP materials by specific gravity
73
What tool utilizes specific gravity
CLIK. | Identified specific rigid lens material by seeing if the lens sank
74
How do you measure surface quality of a lens
Slit lamp Loupe Projection system
75
Which two blend types are associated with good comfort and good physiological response
Medium | Heavy
76
Which blend type is it difficult to identify the junction b/w the OZD and Peripheral curve system?
Heavy. | Due to excess polishing.
77
Name the three types of Edge Shape and contour
Sharp Smooth or well-tapered BLunt
78
Which two edge shapes lead to pt discomfort
Sharp | Blunt
79
HOw do you identify Edge shape
Slit lamp Projection System Palm Test
80
What are the goals of a lens care system
Good comfort Clear vision Optimum corneal health
81
What are some challenges in creating the ideal lens care system
1. Microbial growth w/o corneal toxicity 2. Pt non-compliance 3. Misuse of solns 4. Pt preservative sensitivity 5. Lens contamination
82
T/F | SCLs provide fewer opp for lens care products to be absorbed into the lens matrix
Falso
83
T/F | Higher wetting angle is good
False
84
T/F | SCL soln can be used with GP lenses
True
85
How long does it take to adapt to lid sensation?
1-3 weeks
86
Which type of GP lens is known to accumulate lipid deposit problems
Higher Dk F-S/A | Fluoro-Silicone Acrylate
87
Which type of GP lens is known to accumulate protein deposit problems
S/A Polycon II Low Dk?
88
How to utilize Walgreen's Daily cleaner with GPs
Used in office as an extra strength lab cleaner. Not approved for Daily Use - will cause crazing Contain alcohol
89
Which products contain alcohol?
Walgreen's Daily cleaner Lobob Optimum Menicare
90
Which product is similar to Walgreen's daily cleaner?
Miraflow
91
Name the preservative free solns
1. Unisol Saline 2. Aerosol Saline 3. Unit dose 0.9% sodium chloride inhalation soln
92
Which product is used off-label
Unit dose 0.9% sodium chloride inhalation soln | Not that expensive
93
Is it ok to utilize MPS with scleral lenses?
Nope. | Due to stagnant tear reservoir
94
What products can you use for rinsing off GP lenses?
MPS | Preservative free saline
95
Which two products do you avoid with Menicon Z?
Boston Original | Boston Advance
96
How long do you need to store GP lens in Boston's conditioning system?
4 hours
97
Preservative in Boston Original
Chlorihexidine
98
Preservative in BOston Advance
Chlorihexidine Biguanide
99
Name the Boston one bottle system?
Boston Simplus Multi Action Soln
100
Can you use BOston simplus with Menicon product?
Yes. | Bcaz there is not an abrasive cleaner.
101
Name the product with the preservative Subtilisin A
Boston One Step Liquid enzymatic Cleaner It is a drop instead of a tablet. "we are backing away from enzyme products"
102
Name the preservative in Boston Rewetting drops
Chlorihexidine Gluconate
103
T/F | ALcohol is a true preservative
False
104
Can the optimum solns be placed directly into the eye?
Nope | Needs to be rinsed off
105
How many products can you have to use optimum products
``` 3-4 CDS Re-wetting Drops Saline ( need to use twice). Extra-strength cleaner ```
106
Which product is similar to the Lobob Optimum product?
Menicare
107
Which product smells like bleach?
Menicon Progent | Only recommend for ppl who are good at following directions.
108
Do we dispense plungers more with scleral lenses or GP lenses?
Scleral | We don't use plungers for SCL.
109
If a pt had excess lipid buildup on GP lens, what would you recommend?
Optimum | Menicare
110
If a pt had excess protein buildup on GP lens, what would you recommend?
Boston 2 step | Enzyme cleaner
111
How long do you leave GP lens in Menicon progent vial of mixtures A and B
30 mins. If longer; will discolor lens.
112
T/F | A pt can utilize peroxide base systems for GP lens
False | Can use for scleral lens.
113
What is the soln for flare?
``` Increase OZD (AOD) Improve lens centration ```
114
What is the soln for 3-9 staining
Improve edge design | Improve lens centration
115
What is the soln for low-riding lens
IF LA - flatten BCR &/or increase OAD If IP - steepen BCR -decreasing overall mass by lenticular design, decreasing thickness, or both
116
Soln for high riding lens
If LA-Steepen BCR &/or decrease OAD
117
What is it called when you do not have an edge trt
Single cut
118
T/F | A steeper lens is less likely to result in a low-riding lens
True Thus if LA - flatten BCR and/or increase OAD If IP - steepen BCR
119
What are the solns for Lens Adhesion
Flatten BCR Decrease OZD Flatten peripheral curve radius.
120
Which way can a WTR cornea decenter the lens?
High or low
121
Which way can a ATR cornea decenter the lens
Side to side
122
How does crazing result
From alcohol based cleaners or solvent
123
What is flexure
Lens that r bending on the eye
124
What is warpage
Mangled lens that is off of te eye.
125
What is the soln for dry spots
Remake lens if due to excessive heat during manufacturing Improve pt compliance w/ care system Augment w/ special cleaners like alcohol.
126
Soln for Warpage
Handle more gently Increase thickness Utilize more stable material Avoid smooth welled case.
127
Soln for Flexure
Increased thickness Avoid steep BCR and large OZD Utilize more stable material.
128
Soln for Decentered lens
Avoid excessively flat or steep BCR | Toric Lens BCR
129
Which solns should not be utilized immediately prior to lens insertion?
Optimum Menicare Menicon Progent

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