Lecture 1 Soft CL WorkUp slide 83.pdf

42 43 -second pic in left à chalazion while active, the pt will say the CL is uncomfortable or displaced temporally bc upper lid is swollen so it moves the lens temporally 44 -topical meds oftentimes have preservative which can complicate their CL wear and shouldn’t be taking this while weari...

42 43 -second pic in left à chalazion while active, the pt will say the CL is uncomfortable or displaced temporally bc upper lid is swollen so it moves the lens temporally 44 -topical meds oftentimes have preservative which can complicate their CL wear and shouldn’t be taking this while wearing CL -dosage or amount applied with CL on will not be adequate to get to the epithelium -there is a buildup of contents in the CL and that will leech out of the lens throughout the time the CL is worn and cause a toxic environment for the epithelium -place topical drops either before or after CL wear and if it’s a daytime drug, wait 15 mins before reapplying CL 45 -scar tissue on bulbar conj -common diameter for soft CL is 14 mm -common diameter for astigmatic lens CL is 14.5 mm -so you have to either give the pt a smaller diameter or larger diameter CL if they have scar tissue but you don’t want CL edge on the scar or it will irritate them 46 47 -monovision à dominant eye relies on distance vision and non dominant eye gets near vision so both eyes won’t see equally well but gives you the ability to see at all distances -pt may fail if they abuse their CL and don’t change their lenses at appropriate times -CL accumulate biofilms over days of wear so if pt is prescribed to wear lenses for 14 days and wears it for 30 days are at risk for adverse effects 49 50 51 -biotrue is a cleaning/CL solution -they all have a surfactant to clean the surfaces as well as kill bactericidal bacteria but make sure the CL is safe to bc it can also be irritating to the pt eye and can be solved by using a non preservative solution instead 52 -these are alternatives, non-preservative CL solutions 53 54 -air controlled environments such as a building can affect the pts CL wearing experience and will experience more symptoms compared to when they are outdoors -ortho k is another option for swimmers or wearing goggles over CL 55 56 57 -measuring vertical aperture and horizontal visible iris diameter -people can have smaller or larger HVID and have to accommodate to pt needs -know highlighted -if you leave pt slightly blurry in the dominant eye or their rx is slightly off, pt will notice it 58 59 60 -pt at the top image, there is a diff in right and left eye and if everything is normal, you would need to fit the pt in two diff vertical apertures -not necessary to be the same vertical aperature in both eyes 61 62 -air optics 7.5mm: if a pt has a 8mm pupil size under dim light then the CL would be smaller for the pt so its impt to measure pupil size so let the pt know this is the best we can do and that the image can be blurry before the pt complains 63 64 -not impt 65 -use topography to measure corneal shape 66 67 68 69 70 71 72 73 74 75 76 -flat value: 45.4D -steep value: 45.9D à always the higher number -image on bottom right the curvature in the horizontal is dff from vertical so horizontal is the flat value and the vertical is the steeper value 77 -flattest is the horizontal meridian bc it has the lowest diopter -steeper is the vertical meridian bc it’s the higher diopter -good representation of WTR astigmatism cornea 78 -we are more focused on the flattest corneal curvature -pt with refractive surgery would have flat K value post surgery 79 -regular WTR bc the axis are 90 degree away from each other 80 -can fit this pt with a cosmetic CL -vertical meridian is steeper than horizontal meridian 81 -horizontal meridian is steeper than vertical meridian 82 -irregular or no symmetry but there are areas of elevation or steepness -cannot fit pt with cosmetic soft CL -stopped here*** 83