Contact Lenses Overview and Management

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Questions and Answers

What is a principal advantage of wearing contact lenses compared to spectacles?

  • Contact lenses are less expensive.
  • Contact lenses are easier to lose.
  • Contact lenses can be used in wet environments. (correct)
  • Contact lenses require no cleaning.

Which type of contact lens is typically more difficult to adapt to and requires a consistent daily wear schedule?

  • Colored lenses
  • Hard lenses (correct)
  • Soft lenses
  • Disposable lenses

Which issue may patients experience when wearing soft contact lenses?

  • Better vision than with hard lenses
  • Increased risk of corneal scarring
  • Allergic reactions from lens substances (correct)
  • Apparent visual clarity in all situations

What is a disadvantage of hard contact lenses?

<p>They are brittle and unsuitable for contact sports. (B)</p> Signup and view all the answers

Which types of corrective issues can hard lenses address that soft lenses typically cannot?

<p>Keratoconus and corneal scarring (C)</p> Signup and view all the answers

Why do some patients find contact lenses less convenient than spectacles?

<p>Contact lenses need to be cleaned and managed on a regular basis. (A)</p> Signup and view all the answers

What characteristic is true for soft contact lenses?

<p>They wrap onto the corneal surface and have high water content. (D)</p> Signup and view all the answers

What is a common reason patients choose contact lenses?

<p>They allow for greater flexibility in wearing schedules. (B)</p> Signup and view all the answers

What is the recommended action for a patient with a corneal abrasion caused by contact lenses?

<p>Apply antibiotic ointment and leave lenses out for 24 hours (D)</p> Signup and view all the answers

Which factor increases the risk of corneal abrasions in contact lens wearers?

<p>Wearing lenses for extended periods without breaks (D)</p> Signup and view all the answers

What symptom is NOT typically associated with a corneal infection in contact lens wearers?

<p>Positions of contact lenses off-center (B)</p> Signup and view all the answers

What should be avoided to prevent Acanthamoebic keratitis in contact lens wearers?

<p>Using tap water to rinse lenses (D)</p> Signup and view all the answers

Which type of tear supplement is recommended for contact lens wearers experiencing dry eye symptoms?

<p>Low viscosity tear supplements (C)</p> Signup and view all the answers

What should patients with hypersensitivity reactions to contact lens solutions do?

<p>Rinse off the solutions thoroughly or try a new cleaning regime (D)</p> Signup and view all the answers

What is a common recommendation to ensure the effectiveness of unpreserved tear supplements?

<p>Keep them in multiple locations for convenience (D)</p> Signup and view all the answers

What is the primary concern when a contact lens wearer presents with a red eye?

<p>The possibility of corneal abrasions or infections (B)</p> Signup and view all the answers

What is the first step to examine a patient with a potentially displaced contact lens?

<p>Instil a drop of local anaesthetic (A)</p> Signup and view all the answers

Where is a displaced contact lens most likely to be found?

<p>Hidden beneath the top eyelid (D)</p> Signup and view all the answers

When repositioning a displaced contact lens, what should the patient do as you stabilize the lens?

<p>Look towards your finger (D)</p> Signup and view all the answers

What might the patient experience if a contact lens is displaced?

<p>Pain and distress (C)</p> Signup and view all the answers

How can you help stabilize a soft contact lens during repositioning?

<p>Dry your finger on a clean gauze pad (B)</p> Signup and view all the answers

What should be done after successfully repositioning a displaced lens?

<p>Ask the patient to remove the lens (B)</p> Signup and view all the answers

Why is it important to ascertain whether a contact lens is on the eye or not?

<p>To avoid unnecessary anesthetic application (D)</p> Signup and view all the answers

What should you avoid telling a patient who believes their contact lens is behind their eye?

<p>They should try to find the lens themselves (B)</p> Signup and view all the answers

What is a common reason for patients experiencing difficulty removing their contact lenses?

<p>Vacuum development beneath the lens (B)</p> Signup and view all the answers

Which technique is recommended for breaking the vacuum under a stuck lens?

<p>Push the lid margin backward onto the lens (A)</p> Signup and view all the answers

What is the first step to take if a patient is unable to remove their lenses due to severe pain and swelling?

<p>Instill a drop of local anaesthetic (A)</p> Signup and view all the answers

Which of the following is a necessary follow-up treatment after lens removal in cases of acute overwear?

<p>Instilling a cycloplegic agent (A)</p> Signup and view all the answers

What should be done if a hard contact lens breaks?

<p>Remove obvious shards and refer the patient for a review (B)</p> Signup and view all the answers

What should never be done with a contact lens in place?

<p>Instill fluorescein into the eye (C)</p> Signup and view all the answers

How can a patient temporarily store contact lenses?

<p>In saline solution using a specimen pottle (C)</p> Signup and view all the answers

What is a symptom of hypoxia and oedema caused by acute contact lens overwear?

<p>Severe pain and discomfort (D)</p> Signup and view all the answers

Flashcards

Why choose contact lenses?

Contact lenses provide good vision in wet environments and are great for playing sports.They are also ideal for patients with keratoconus or high myopia who may see better with contact lenses than glasses.

What are the optical benefits of contact lenses?

Contact lenses correct refractive errors and improve vision. They are less likely to fog up and can't be knocked off like glasses.

What are hard contact lenses made of?

Contact lenses are made of a material that allows oxygen to pass through, so they are considered 'gas permeable'. They sit on the cornea and act as a replacement for the front surface of the eye.

What are some advantages of hard contact lenses?

Hard contact lenses can correct a wider range of vision problems, including keratoconus & scarring on the cornea.

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What are the benefits of soft contact lenses?

Soft contact lenses are more comfortable and easier to wear.

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What is a disadvantage of soft contact lenses?

Soft contact lenses wrap themselves onto the cornea. They are less likely to provide as sharp vision as hard lenses, especially for patients with irregular corneas or high astigmatism.

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What are some disadvantages of hard contact lenses?

Hard lenses are more brittle and unsuitable for contact sports.

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What is a potential problem that can occur with soft contact lenses?

Soft lenses are more susceptible to allergen buildup, leading to eye irritation.

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Corneal Abrasion

A scratch on the cornea, often caused by contact lens insertion or removal, or trauma.

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Corneal Infection

Inflammation of the cornea, often caused by contact lens wear.

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Acanthamoebic Keratitis

A rare but serious infection of the cornea caused by a type of amoeba, often from using contaminated solutions.

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Dry Eyes and Contact Lenses

Contact lenses can worsen or cause dry eye symptoms.

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Contact Lens Sensitivity

A reaction to contact lens solutions, causing redness and irritation.

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Lens Displacement

A contact lens that is not properly centered on the eye.

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Corneal Epithelium

The outer layer of the cornea, responsible for healing after abrasions.

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Sterile Immune Ulcer

A common type of corneal ulcer that occurs in contact lens wearers.

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Contact Lens Repositioning

The act of repositioning a contact lens that has become displaced from the cornea.

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Cornea

The outer transparent layer of the eye that covers the iris and pupil.

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Patient Gaze Direction

The process of asking the patient to look in a specific direction to help reposition the contact lens.

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Tear Film

A thin layer of lubricating fluid found between the contact lens and the cornea.

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Epithelial Abrasions

Small scratches or abrasions on the surface of the cornea.

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Contact Lens Centering

Positioning the contact lens directly over the center of the cornea.

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Illumination

The process of using a light source to locate a displaced contact lens.

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Cornea Curvature

The ability of the cornea to change its curvature, allowing the contact lens to reposition itself.

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Stuck Contact Lens

A condition where a contact lens becomes stuck to the eye due to a vacuum forming under it.

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Acute Overwear

When a patient wears contact lenses for an extended period, causing corneal hypoxia and edema, leading to pain.

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Broken Contact Lenses

Damaged contact lenses that can cause corneal injury due to sharp fragments.

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Fluorescein & Contact Lenses

Never instilling fluorescein into an eye with a contact lens in place, as the dye can permanently stain and damage the lens.

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Storing Contact Lenses

Using a specimen pottle with saline solution to temporarily store a patient's contact lens.

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How to Remove a Stuck Lens

Gently pressing on the edge of a stuck contact lens to break the vacuum and facilitate removal.

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Removing a Stubborn Lens

Using a small surgical instrument to carefully lever a contact lens off the eye if other methods fail.

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Relieving Overwear Pain

Instilling local anesthetic to enable the patient to remove their lens during acute overwear.

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Study Notes

Contact Lenses

  • Contact lenses are worn for cosmetic and optical reasons
  • Benefits include no fogging, weather suitability, and improved vision in specific cases (e.g., keratoconus, high myopia)
  • Drawbacks include cost, inconvenience (cleaning and solutions)

Types of Contact Lenses

  • Hard lenses: Rigid, partially gas-permeable, replace corneal surface effectively. More difficult to adapt to, but suitable for wider refractive issues like keratoconus
  • Soft lenses: More adaptable, flexible wearing schedule, ideal for sports, high water content, wrap onto cornea. May not provide as sharp of vision as hard lenses

Contact Lens Problems and Management

  • Corneal abrasions: Can occur during lens insertion/removal or trauma. Treat as with any other abrasion (antibiotic ointment, cycloplegic, pad) and remove lens for 24 hours to allow healing.
  • Red Eye: Contact lens wearers may experience red eye due common causes but also have a higher incidence of corneal abrasions and infections.
  • Dry eyes: Contact lenses can worsen or trigger dry eyes, especially in smoky/air-conditioned environments. Add tear supplements (Tears Plusâ„¢, Poly-Tearsâ„¢, Tears Naturaleâ„¢), single-use unpreserved tear supplements (Refresh) for these cases.
  • Itchy eyes: Hypersensitivity to lens solutions can cause redness and irritation. Try rinsing solutions more thoroughly, or switching to a new cleaning regime. Consult optometrists, ophthalmologists, or pharmacists for advice.
  • Lens displacement: Lenses may become dislodged. Examine whether a lens is truly present, use local anesthetic, and reposition lens using gentle movements to restore the lens to the cornea.
  • Stuck lenses: Difficulty removing lenses may occur due to vacuum beneath the lens. Gentle pressure on the lens edge or local anesthetic may help. If unable to remove, consult with a health professional.
  • Acute overwear: Prolonged contact lens wear (e.g., overnight) can cause corneal hypoxia and edema, leading to severe pain. Always remove lenses before sleeping.

General Tips

  • Fluorescein and Contact lenses: Avoid instilling fluorescein solution when contact lenses are present as it can permanently stain some soft lenses.
  • Storing contact lenses: Use a specimen pottle filled with saline solution for short-term storage.
  • Finding lost lenses: Patience, check face/clothes, use dim lighting to find reflections.
  • Referring patients: Chronic issues (discomfort, dryness), infection signs require immediate referral to an ophthalmologist bypassing optometrist; avoid antibiotic instillations.
  • Broken Lenses: Remove visible lens pieces, refer to optometrist/ophthalmologist for evaluation.

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