Contact Lens Assessment Quiz

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Questions and Answers

What is the primary purpose of assessing the history and symptoms of a prospective contact lens wearer?

To prescribe new medications for eye conditions

To evaluate the patient's current lens care routine

To suggest alternative vision correction methods

To determine the suitability of contact lens wear (correct)

Which of the following factors is NOT considered when selecting appropriate contact lenses for a patient?

Budget for lens purchase (correct)

Environmental factors

Motivation for lens wear

Patient's lifestyle

What information is essential for the initial assessment of a prospective contact lens wearer?

Patient's preferred lens color

Previous eye surgeries

Family history of eye diseases

Refractive error (correct)

Which of the following does not fall under the category of patient education regarding contact lenses?

The financial cost of purchasing lenses Signup and view all the answers

What is a potential outcome of incomplete record-keeping during the initial assessment of a contact lens wearer?

Inaccurate clinical decision-making Signup and view all the answers

What is the recommended action for a patient with blepharitis regarding contact lens wear?

Avoid contact lens wear until clear Signup and view all the answers

Which condition is associated with reduced epithelial healing?

Diabetes Signup and view all the answers

What effect do beta-blockers and diuretics have on contact lens wear?

They may cause dry eye Signup and view all the answers

Which of the following factors should be monitored when a patient is using oral contraception?

Corneal contour changes Signup and view all the answers

Due to changes in corneal sensitivity, which patient group might require careful assessment before fitting contact lenses?

Patients undergoing psychotropic medication treatment Signup and view all the answers

Which best describes the approach to taking a case history for non-contact lens wearers?

Ask about reasons for the visit and previous lens usage if applicable Signup and view all the answers

What is a primary goal when building rapport with a patient during an optometry session?

To encourage open communication and use open-ended questions Signup and view all the answers

Which of the following conditions should lead to advising a patient to avoid contact lens wear?

Mucus deficiency deposit build-up Signup and view all the answers

What is the primary purpose of a detailed case history in clinical practice?

To guide future clinical decisions Signup and view all the answers

Which factor is NOT typically considered when determining indications for contact lens wear?

Geographic location Signup and view all the answers

Which systemic medication is most likely to impact contact lens tolerance?

Antihistamines Signup and view all the answers

What physiological change is commonly associated with the aging of the eyes?

Reduced lacrimal secretion Signup and view all the answers

In which situation would the use of one-day disposable contact lenses be most advisable?

Atopic conjunctivitis Signup and view all the answers

What potential problem is associated with the use of systemic medications in patients wearing contact lenses?

Preservative reactions Signup and view all the answers

Which of the following factors would NOT affect the choice of contact lens type for a patient?

Patient's hairstyle Signup and view all the answers

Which of these conditions is associated with excessive deposits on contact lenses?

Atopic conjunctivitis Signup and view all the answers

What is the first step to take if a contact lens is damaged?

Remove the contact lens and inspect it. Signup and view all the answers

Which of the following is NOT part of the record-keeping process for a new patient's initial appointment?

Detailed examination of the posterior eye Signup and view all the answers

What should be done before inserting a rigid gas permeable (RGP) lens?

Clean hands and clean and rinse the lens thoroughly. Signup and view all the answers

What is the purpose of record keeping in clinical practice?

To offer insight into ocular status and provide clinical credibility. Signup and view all the answers

After experiencing problems with a contact lens, if the issue persists after removal, what should the patient do next?

Consult a contact lens practitioner. Signup and view all the answers

What is the correct sequence for recording curvature meridians during keratometry?

Record horizontal meridian first, then vertical Signup and view all the answers

How long should a rigid gas permeable (RGP) lens be allowed to settle before assessing the fit?

15 minutes Signup and view all the answers

What is an essential condition for keratometry measurements?

Adjust the patient's position for comfort Signup and view all the answers

What should be done if a contact lens problem recurs after cleaning, rinsing, and disinfecting?

Stop wearing the lenses and seek immediate advice. Signup and view all the answers

Which item is included in the clinical record during the initial patient examination?

Contraindications found in the examination. Signup and view all the answers

Which of the following is NOT a type of contact lens mentioned?

Silicone elastomer lenses Signup and view all the answers

What innovation in the evolution of contact lenses occurred in 1974?

Introduction of rigid gas-permeable lenses Signup and view all the answers

What is a possible benefit of using contact lenses over glasses?

Greater field of vision Signup and view all the answers

Which of the following aspects is NOT addressed when performing baseline measurements for contact lens fitting?

Measuring central corneal curvature Signup and view all the answers

Which year marked the introduction of disposable contact lenses?

1988 Signup and view all the answers

What was one of the first materials used to create contact lenses in 1936?

Plastic Signup and view all the answers

Which of the following lenses is specifically designed for therapeutic purposes?

Therapeutic lenses Signup and view all the answers

What should be avoided when performing keratometry measurements?

Switching on room lights Signup and view all the answers

What is the first action taken if a user experiences discomfort on lens insertion due to a foreign body?

Rinse and re-insert lens Signup and view all the answers

Which of the following is NOT a factor to be evaluated in existing lens wearers?

Age of the wearer Signup and view all the answers

What should be done when a contact lens is causing discomfort after a period of wear due to lens deposit?

Replace the lens Signup and view all the answers

When experiencing corneal inflammation after lens removal, which action is recommended?

Seek medical advice Signup and view all the answers

What is one of the benefits of contact lenses that should be communicated to new lens wearers?

They provide a wider field of vision Signup and view all the answers

What is the purpose of the daily decision tree for contact lens wearers?

To assess whether to continue lens wear based on symptoms Signup and view all the answers

Which action should be taken for a decentered lens that causes discomfort?

Re-center and check lens fit Signup and view all the answers

Which of the following is a common sign indicating that a contact lens wearer should stop using their lenses immediately?

Blurred vision Signup and view all the answers

Study Notes

Baseline Measurements & Keratometry Feedback

Patient eye level alignment is important
Align the canthus
Adjust the prescription for patient comfort
Turn off lights during keratometry (Ks) procedure
Keep hand on the joystick
Meridians may not be at 180 and 90 degrees
Record horizontal meridians first, then vertical
Curvature and meridian not achieved
Curvature achieved but meridian not achieved
Curvature and meridian achieved

Baseline Measurements & Keratometry Feedback (Errors)

Measuring not centered on the cornea
Measurement too far to the left
Measurement too far to the right

Introduction to Contact Lenses & History & Symptoms

Introduction to contact lenses and history and symptoms overview

Lecture Outline – Introduction to Contact Lenses

Brief history of contact lenses
Types of contact lenses
Benefits of contact lenses
Advantages of scleral and rigid gas permeable lenses
Contact lens parameters
Contact lens fitting
Contact lens fitting routine

Brief History of Contact Lenses

Leonardo da Vinci's idea to alter corneal power
Fluid-filled tube described by Rene Descartes
Eye cup design of Thomas Young
'Animal jelly' sandwiched between a spherical capsule of glass and the cornea

Evolution of Contact Lenses

Timeline of contact lens evolution, from glass lenses (1888) to silicone hydrogel lenses and beyond
Key developments such as plastic (1948), silicone elastomer (1965), and disposable lenses (1994)
Includes myopia control and photochromic technologies

Types of Contact Lenses

Soft hydrogel lenses
Silicone hydrogel lenses (SiHi)
Rigid gas permeable (RGP) lenses
PMMA lenses
Hybrid lenses
Daily disposable, biweekly disposable, monthly disposable, planned replacement lenses
Prosthetic lenses
Therapeutic lenses
Scleral lenses
Special effect lenses

Benefits of Contact Lenses Compared to Glasses

Natural perception
No edge blurring
Better vision
Larger field of view
No fogging of the lens
No weight or pressure on the nose
Cosmetic appeal (appearance)

Advantages of SCL and RGP

Soft lenses: easy insertion/removal, continuous wear up to 4 weeks
Color change of the eyes possible in some cases
Disposable lenses: no daily care necessary
RGP lenses: stable optical imaging, excellent for high or irregular astigmatism, daytime Ortho-K

Contact Lens Fitting - Lens Parameters

Edge thickness (t_p1, t_p2)
Central thickness (tc)
Back Surface Parameters (r₁, r₂)
Base curve (SCL), BOZR (RGP)
Front Surface Parameters (r_a1)
FOZR
BOZR
Total diameter
Various lens parameters(additional detail)
Material
Oxygen transmissibility (Dk)
Water content (%)

Contact Lens Fitting – Lens Parameters (Additional)

Various lens parameters with specific measurement designations
Material types
Oxygen transmissibility and water content percentages

ACLM Year Book

Lists of disposable lenses
Includes material details, water content, power details, UV protection, and optical design
Listing the manufacturer and their details

Fitting Contact Lenses - Key Points

Only registered optometrists, doctors, or contact lens opticians can fit contact lenses.
Avoid occasional contact lens practice, especially in areas like therapeutic lens fitting.
Discuss contact lens options with your patient(s) to support informed decisions.
Provide the same care standard for all patients regardless of power or whether the lens has added power
Patients with contact lenses must have had a recent sight test.

Fitting Contact Lenses – Key Things

Document details
Inform the patient of possible risks and benefits
Document the information in the patient notes
Avoid fitting yourself
Advice and written info on lens care, cleaning, and maintenance.

Contact Lens Fitting - Routine

Contact lens fitting routine

Information Needed for Lens Selection

History and symptoms
Baseline measurements
Keratometry
Anterior eye assessment
Lens type
Material
Wearing modality
Care system
Refractive power
Parameters
Purpose
Frequency
Lifestyle
Environment
Motivation
Ocular condition
Refractive error

History and Symptoms

Introduction to history and symptoms taking
Importance of H&S
Indications and contraindications of CL wear
The Case History
- Asking questions: new and existing contact lens wearers
Patient Education (information for patients)
Record Keeping

What is History and Symptoms?

Purpose: determine suitability for contact lens wear
- Analyze patient specifics for indications and contraindications
- Risk/ benefit assessment for individual prescriptions
- Provide initial information for contacts, and education, about lens suitability.

Why is H&S Important?

Detailed history for future decisions
Thorough and documented examination needed.
Understanding expected findings during examination
Forming a structure for examination procedures
Insight to manage the patient

Indications & Contraindications of Contact Lens Wear

Patient age
Anatomical factors
Ocular health
General health
- Allergies (specifics)
- Chronic infection
- Metabolic disorders
- Pregnancy, lactation, hormonal changes
- Systemic medication
- Psychological factors (motivation, lifestyle)
- Lifestyle/ occupational issues
- Financial considerations

Effects of Aging on the Eyes

Decreased palpebral aperture
Decreased lacrimal secretion
Reduced tear stability
Decreased tonus of upper and lower eyelids
Increased glare sensitivity
Reduced CS
Effects from systemic drugs
Corneal changes
Ocular media changes
Increased pupil diameter

Possible Effects of Systemic Medications & General Health Status on Contact Lens Wear

Specific types of medications and potential problems for each condition.
Advice for managing potential issues while wearing contact lenses.

The Case History – Asking the Questions

Build rapport with the patient
Utilize open-ended questions
Understand how the information will assist
- In selecting the correct lens
- Helping in future monitoring
Keep eye contact
Explain procedure during the duration of the consultation
Informed decisions made

The Case History – Non-Contact Lens Wearers

Reason for visit
Previous contact lens use
Ocular health (current RX, power, onset, wearing habits, eye conditions, vision problems, surgeries, infections, GP/hospital visits)
General health (allergies, diabetes, thyroid problems, systemic inflammatory conditions, skin conditions)

The Case History – Non-CL Wearers (additional information)

Medications (type, frequency, dosage)
Lifestyle factors (occupational and social)
Expectations (why they want CLs, wearing frequency, duration, and budget)

The Case History – Existing Contact Lens Wearers

Questions for existing contact lens wearers (similar to new patient, with additional questions)
- Type of lens they are currently using
- Date of last fitting
- Changes in lens type
- Modalities of wear
- Frequency of replacement
- Care system utilized

Evaluation of Symptoms

Symptoms related to contact lens wear
Possible causes for symptoms
Action to be taken in response

Patient Education

Reiterate findings from the case history
Inform the patient of the benefits of CL
Inform of the risk of noncompliance
During the assessment, inform the patient of procedures
- Purpose and what can be expected.
Provide and explain options

Daily Decision Tree for Contact Lens Wearers

Daily self-assessment (redness, pain, blurring, tearing, etc.)
Addressing warning signs
Actions based on daily assessment (removal, consult, care, etc.)

Record Keeping

Outline for record keeping, including crucial details for new patients. Specific information to be recorded for initial patient appointments.)

RGP Insertion and Removal

Detailed procedure explanation

RGP Insertion

Pre-insertion steps: cleaning hands and lenses, explain what to expect
Conditioning solutions use

RGP Fitting

Allow the lens to settle for 15 minutes before evaluating fit

RGP Removal

RGP removal procedure

Questions

Questions section

Acknowledgments

List of individuals and organizations acknowledging the contribution to the content of the lecture

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Description

Test your knowledge on the essential factors involved in assessing prospective contact lens wearers. This quiz covers patient history, initial assessments, and education about contact lens use. Understand the implications of various conditions and treatments on contact lens fitting and wear.