9 - scl general management

what are the indications for spherical soft CL?

1. good tear quality and quantity

2. low astig (≤0.75)

3. athletes

4. unable to adapt or complications with GPs

5. motivated

What patients should be fitted in SCL with caution?

1. dry eye patients

2. severe allergies

what are the contraindications for spherical soft CL?

inflammation or ant seg disease

poor hygiene

not motivated

chronic allergies/antihistamine use

autoimmune disease/immunocompromised

dry eye

irregular astig

radial keratometry

dry, dusty environments

giant papillary conjunctivitis/contact lens papillary conjunctivitis

what are the advantages of soft CL?

1. excellent initial comfort

2. minimal adaptation, spec blur, corneal distortion

3. part-time wear possible

4. dislocation uncommon

5. fit and dispense from inventory

6. change/enhance eye color

7. simple to fit

8. disposable/frequent replacement possible

9. therapeutic use possible

what are the disadvantages of soft CL?

reduced VA with uncorrected cyl

limited durability

poor O₂ transmission with hydrogels

deposit formation/GPC/CLPC

increased risk of bacterial infection

more difficult to verify

limited parameters available

does a soft CL create a lacrimal lens?

NO → soft lens drapes on the cornea and takes the shape

what do you Rx when patient has low amounts of cyl (0.25-0.50 D)?

don't Rx cyl in spherical CL

what are some considerations for high myopes?

1. substantial minification in gls

2. must vertex from phoropter/trial frame

what are the options for measuring vertex distance?

1. phoroptor

2. gauge on trial frame

3. distometer

what are the disadvantages of the phoroptor vertex gauge?

1. difficult to read

2. hard to monitor pt to determine if distance was consistent

what is the downside to measuring vertex distance off a trial frame?

less precise than distometer

how to use the distometer?

1. place refraction in trial frame

2. complete binocular sphere check

3. have pt close eyes

4. measure vertex → add 1 mm unless already added by manufacturer