Preliminary Evaluation Part 2

ODT IV

What is HVID?

Horizontal, Visible, Iris Diameter

“White to white”

What does the HVID determine?

Diameter of Contact Lens

What is important about the Pupil Diameter?

Optical Zone of CL. You want to cover the Pupil

What is important about measuring Palpebral fissure?

Distance between upper and lower lids. Helps determine CL Diameter.

What does Anterior Blepharitis potentially indicate?

Bacteria and/or DEMODEX

What does Posterior Blepharitis indicate?

Meibomian Gland Dysfunction

What are the 3 main dyes used to stain the eye?

Sodium Fluorescein

Lissamine Green

Rose Bengal

What does Positive NaFl staining indicate?

Small breaks in epithelium

What does Negative NaFl staining indicate?

Raised/irregular epithelium

What does NaFl show?

Defects in epithelium

What does Lissamine show?

DEAD or degenerated cells

What does Rose Bengal show?

Dead or degenerated cells

What grade is “Giant” Papillary Conjunctivitis?

Grade 3-4

What can cause GPC?

Mechanical Irritation from CL

**Usually indicates extended wear of CL

When assessing the Cornea, what are you looking for?

Limbal Vasculature

RULE OUT Neovascularization

Baseline

Are CL contraindicated?

When staining the cornea, what are you looking for?

Just use NaFl

Describe (diffuse, localized, etc)

Is it Punctate?

Location

What else are you looking for when assessing the cornea?

Edema

Scarring

Infiltrates or ACTIVE INFLAMMATION

Endothelium (Fuch’s Dystrophy, Polymegathism)

What are you assessing when looking at the Tear Film?

Dry Eyes

Can the tear film handle CL?

When assessing tear film, how do you do that?

TBUT

Vital dyes testing

Lid Wiper Epitheliopathy

Schirmer testing

Dry Eye Questionnaire

What indicates dry eyes?

Tear Osmolarity: >308 mOsm/L

MMP-9 levels may be increased

***Can use Inflammadry, ScoutPro, I-Pen

What is all part of a Refractive Evaluation for CL’s?

Objective refraction (AR, Ret)

Subjective refraction

Keratometry (Auto-keratometry, Manual, Tomography, Topographer (Sim-K’s))

What indicates you can PROCEED with CL’s?

Normal, healthy ocular surface

Patient is motivated

Vision is improved/stable

Comfort is improved/stable

When should you PROCEED W/ CAUTION with CL’s?

Pregnancy

Vision not improved

Patient is unmotivated

Young Child WITHOUT parent involvement

Severe Dry Eye

Amblyopia

Monocular

When are CL’s CONTRAINDICATED?

Active INFLAMMATION

Activ INFECTION

Severe endothelial disease

Severe Blepharitis

Mentally impaired

What is Corneal Guttata

formation of small, droplet-shaped bumps on the inner layer of the cornea, often leading to vision problems and associated with Fuchs' dystrophy.