full_aftercare_routine_flashcards
(32 cards)
What are the main components of a preliminary question in aftercare?
RFV, LAC, LEE, spectacles up to date, vision with and without specs, and how long the patient has worn contact lenses.
What should be assessed about the current contact lenses a patient is wearing?
Brand and modality, age of the current pair, WTT, AWT, MWT, and how many days per week the lenses are worn.
What dynamic fit checks should be performed during contact lens fit evaluation?
Centration, comfort, position of the lens in relation to lids, movement on version, and MOB.
What static fit evaluation steps are needed during contact lens fit assessment?
Observer angle (0°), illumination angle (0° or 30°), slit width/height maximum, light cobalt blue, filter Wratten #12, magnification 10-16x.
How can TBUT values determine the suitability of contact lenses?
> 15 secs = CLs suitable, 10-15 secs = suitable, 5-9 secs = limited suitability, <5 secs = contraindicated.
What handling technique questions should be asked during aftercare?
How lenses are put in and taken out, storage, solution change, cleaning/replacement of lenses and cases for monthly lenses.
What questions should be asked regarding past ocular history (POH)?
Any diagnosed eye conditions, flashes, floaters, diplopia, headaches, surgeries, trauma, or patching as a child.
What family ocular history (FOH) questions are important?
Ask about family history of eye conditions, such as glaucoma or AMD.
What should be asked about a patient’s general health (PGH)?
Any general health conditions, medications, allergies, high blood pressure (HBP), diabetes (DM), and smoking status.
What factors should be considered regarding lifestyle in contact lens wearers?
Occupation, visual display unit (VDU) use, hobbies, and driving habits.
What should be included in over-refraction during aftercare?
Distance VA, over-refract (+1.00 and duochrome), final distance and near VA.
How should tear prism height be evaluated in contact lens wearers?
G1 >0.3mm, G2 = 0.2mm, G3 <0.1mm.
What are the key factors to assess during a health check using a slit lamp?
Conjunctival redness, blepharitis, MGD, limbal redness, neovascularization, corneal ulcers, tear quality.
What are common signs of a steep fitting contact lens?
Good centration, minimal movement on blink, stable vision, central pooling, relatively comfortable.
What are common signs of a flat fitting contact lens?
Poor centration, excessive movement on blinking, crosses limbus on excursions, unstable vision, central touch, uncomfortable.
What grading terms are used to evaluate a contact lens fit on the apex?
Apical alignment, apical pooling, apical touch.
What are typical management options for blepharitis in contact lens wearers?
Use warm compresses, tea tree oil wipes, and ocular lubricants. Cease lens wear for severe cases (Grade 3 or 4).
How is MGD managed in contact lens wearers?
Continue lens wear if tolerated, use artificial tears, and consider low-water-content lenses to prevent the lens from absorbing the tear film.
What causes bulbar conjunctival staining, and how is it managed?
Mechanical trauma from lens edge, decentration, tightness, or solution toxicity. Managed with blinking exercises, lubricants, or changing the lens fit.
What causes bulbar conjunctival hyperaemia, and how can it be managed?
Caused by solution toxicity, dry eyes, infection, or corneal hypoxia. Managed by refitting with higher Dk/t lenses or using ocular lubricants.
How is contact lens-associated papillary conjunctivitis (CLPC) managed?
Change care system, reduce edge clearance, or switch to a lower modulus lens.
What causes neovascularization in contact lens wearers, and how should it be managed?
Caused by hypoxia. Managed by ceasing lens wear for severe cases, increasing Dk/t lenses, or reducing lens wear time.
What is the management protocol for superficial punctate epithelial erosions (SPEE)?
Remove lenses for 24-72 hours, use lubricants, and adjust solution or lens material.
What causes inferior epithelial arcuate lesions, and how should they be managed?
Typically caused by rapidly evaporating tear film or incomplete blinking. Managed by removing lenses for 24-72 hours, using lubricants, and switching to lower water content lenses.
