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CLII > CLII_Final > Flashcards

CLII_Final Flashcards

1
Q

Why was piggyback invented?

A

Effort to improve the comfort and stabilization of GP lenses.

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2
Q

Cons of piggyback

A

Need to handle twolenses

Oxygen transmittance need to go through two lenses

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3
Q

Name the only company that makes a hybrid?

A

SynergEyes Inc

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4
Q

Which GP center does Synergeyes use?

A

Paragon HDS

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5
Q

T/F

Synergeyes hybrid lenses are FDA approved for pts with Keratoconus?

A

True

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6
Q

Name some candidates for Hybrids

A

Regular and Irregular corneas
Prolate and oblate cornes
Presbyopia
Keratoconus

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7
Q

Is it recommended to fit a hybrid on a nipple cone?

A

Nope

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8
Q

Which pts would other ODs rec hybrid lens for?

A

Corneal GP intolerant
Soft toric pts w/ too much rotation
Soft multifocal pts that want improved optics

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9
Q

What do you use to evaluate hybrid lens

A

A high molecular wt NaFL like FLuorosoft

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10
Q

Name the 4 diff kinds of SynergEyes products

A

A - typical ametropia
M = multifocal
KC - keratoconus
PS - post surgical, oblate cornea

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11
Q

What is the purpose of SynergEyes ClearKone lens?

A

TO fit a wider spectrum of moderate-severe KC patients.

  • it has been known to fit better on decentered cones
  • has a reverse curve in the GP portion
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12
Q

What kind of MF design are the Duete MF and progressives?

A

Simultaneous.

It has a near center and aspheric optics.

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13
Q

Name the two near zone sizes for the Duette MF?

What about the progressive?

A 
MF = 2.8mm and 3.3 mm. The smaller value = power is concentrated and transitions quickly. Most pts do better with this. 
Progressive = 3.0mm
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14
Q

List the add powers available for the Duette progressive

A 
\+1.00 D
\+1.75 D
\+2.50 D
The Duette MF = change in size
The Duette Prog = change in power
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15
Q

List the 2nd generation designs for SynergEyes

A

Duette HD
Duette MF
Ultrahealth

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16
Q

How do you fit the SynergEyes A, MS, PS lens

KC?

A

Choose first lens based on topography.
Use mean K
Manufacturers err on the side of clearance

KC lens = steep K

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17
Q

How do you fit the ClearKone lens

A

Begin the fit with the same diagnostic lens everytime
250 vault/Med skirt lens
(Change the vault until you have slight bearing then add 100 microns)

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18
Q

T/F

Can you use regular NaFL with Ultrahealth?

A

True

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19
Q

How do you fit the Ultrahealth lens?

A

250 vault/Flat

Change the vault until you have slight bearing then add 100 microns

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20
Q

How do you fit Duette soft skirt

A

A med skirt on one eye

A Flat skirt on the other other eye.

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21
Q

List some contraindications for IOLs

A

Intraocular dz
Trauma
Recurrent uveitis
Compromise to iris, corneal endothelium or A/C

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22
Q

Describe the corneal curvature for an infant

A

Flattening happens over the first six months
The mean is 47D
Flattening to adult values by 4 years of age
The cornea is steeper in pre-term infants

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23
Q

Describe the corneal diameter

A

Avg 9.8mm
Reach adult values by age 4
Pre-term infants have smaller OAD

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24
Q

Describe the RE for an infant

A

At one month: +31D
At 4 years: +21D
Most of the change happens within the first 1.5 years

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25
Q

Where is the infant’s world

A

At near!!!

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26
Q

How do you fit an infant

A

Steep BCR

Smaller OAD

27
Q

Describe the order for lens care procedure

A
  1. Removal and recentering of lens
  2. Insertion
  3. Cleaning and disinfecting
28
Q

How often for RTC

A

Begin weekly and proceed to monthly in infants
Monitor infants q3months when fit is successful.
If using patching therapy - see infant every month
-Extended/continuous wear require more frequent monitoring

29
Q

What is the name of GP lens for an infant

A

Pediasite

-has its own flourescein pattern

30
Q

T/F

Hydrogel and SiHy is a lot harder to handle on a child

A

True

31
Q

Name a Silicone elastomer lens

What are the advantages

A

Silsoft by B&L
Dk = 340 - approved for overnight wear
Facilitates lens centration and limits dislocation

32
Q

Name some cons for Silsoft

A

Expensive
Poor wetting if surface is compromised
Predisposition for lipid deposition
Limited parameter availability

33
Q

B/w SiHy and GP lens, which is less likely to dislocate

A

SiHy.

Semi-scleral is less likely to dislocate as well.

34
Q

Remember to do vertex distance for any Rx over 4D

A

Yessir!!!

35
Q

What is a GP consideration for a thick lens?

A

Avoid low Dk material!

Hema lens are the lowest Dk lens

36
Q

What is the benefit of a single cut lens?

A

Small diameter decreases overall mass and facilitates centration

37
Q

What is the value for a non-lenticular lens

A

0.18mm for plano

38
Q

What is the value for a lenticular lens

A

0.14mm

39
Q

How much thickness do you add for each diopter of plus

A

0.02

40
Q

How much thickness do you subtract for each diopter of minus?
What is the minimum amount?

A

0.01

Minimum of 0.10mm

41
Q

where did OrthoK like procedures make its debut?

A

China.

Used sandbags

42
Q

Name a big contributor to OrthoK

A

Sanford Ziff

43
Q

How were OrthoK lens fit in the past

A

Moderately flatter than the patients cornea.

  • poor centration
  • Induced irregular astigmatism
44
Q

Name some milestones in OrthoK development

A
  1. Reverse geometry lenses
    - Improved lens centration
  2. Accelerated OrthoK (days and weeks)
  3. Manufactured in GP lens materials approved for overnight wear
  4. FDA approval facilitated the promotion of the lens, improved public perception.
45
Q

What is a reverse geometry lens

A

SCR is steeper than BCR

46
Q

Name some companies fitting OrthoK lens

A

Paragon - CRT (corneal Reshaping technology)

B&L - VST (Vision Shaping treatment)

47
Q

Name the four lenses that B&L make for OrthoK

A

BE Retainer
Contex OK E-System
DreamLens
Emerald

48
Q

What is the mechanism for OrthoK

A

Central corneal epithelial thinning
Mid-peripheral stromal thickening
Resultant change in corneal sag height

49
Q

Who are the candidates for OrthoK

A 
Low to mod Myopes (-1to-4), up to 06D
Low to mod corneal astigmatism, up to -1.75 WRT is best
Steeper K rdgs(>44D)
Free of ocular pathology
Motivation
Consistency in wearing schedule
50
Q

Describe the overall fitting characteristics

A 
Lens centration is critical
Central bearing 
Paracentral clearance
Mid-peripheral bearing
Peripheral clearance
51
Q

What does RZD and LZ stand for

A 
Return Zone Depth
Landing Zone (Paragon CRT lango for the peripheral curve)
52
Q

Almost always rules……

A

+0.50D
Paragon HDS 100
10.50mm OAD

53
Q

What is doing the vision correction in orthoK?

A

The tear lens

54
Q

What are the three ways you can manipulate an orthoK lens

A

RZD = 25 microns
LZ = 15 microns
BCR: .10mm = 7 microns

55
Q

.500 RZD vs .550RZD

A

.500 RZD = shallow sag depth = more bearing centrally

.550 RZD = steeper sag depth = more central pooling

56
Q

How do u manipulate an orthoK lens with insufficient edge lift?

A 
Decrease LZA (-33 changes to -32)
This will also decrease sagittal depth by 15 microns
57
Q

Step 1: Name the two parameters used to determine the initial diagnostic lense?

A

Determine the flat K

Manifest refraction sphere (MRS)

58
Q

Name the steps to get a good OrthoK fit

A
  1. Determine the initial diagnostic lens
  2. Evaluate the initial diagnostic lens.
  3. Confirm the edge lift.
  4. Perform OR
  5. Dispense the Lens
  6. Follow up
59
Q

define the term progression for OrthoK lens

A

Where the effects of the orthoK lens wear off as the day continues.

60
Q

When do you manipulate the BCR in OrthoK

A

If u find an Over-correction

61
Q

What topography results from too steep a fit in OrthoK lens?

A

Frown Face topography

This is from inferior decentration

62
Q

What topography results from too flat a fit in OrthoK lens?

A

Smiley face topography

This is from superior decentration

63
Q

How do you manipulate too steep a fit in OrthoK

A

Decrease the LZA (Less minus -33 to -32)

or Decrease the RZD

64
Q

How do you manipulate too flat a fit in OrthoK

A

Increase the LZA (more minus: -33 to -34)

or Increase the RZD

CLII (1 decks)

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