4.3_ICLC_Final.pptx contact lens contact lens

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1. Lens Dispensing & Patient Education Module 4.3

2. Copyright Notice The IACLE Contact Lens Course (all formats) is the sole property of the International Association of Contact Lens Educators (IACLE) and is protected, without limitations, by copyright. By accessing this material, you agree to the following terms and conditions: You may only access and use the IACLE Contact Lens Course for personal or educational purposes. Any dissemination or sale of the IACLE Contact Lens Course, either in whole or in part, or use of the materials for other than educational and personal purposes, is strictly prohibited without the express written consent of IACLE. Except as declared below, you may not reproduce, republish, post, transmit, or distribute any material included in the IACLE Contact Lens Course. You may print materials for personal or educational purposes only. All copyright information, including the IACLE logo, must remain on the material. Appropriate reference must be provided to any use of the content of the IACLE Contact Lens Course, including text, images, &/or illustrations.

3. SPONSORS Development and delivery of contact lens education by IACLE is supported through educational grants and in-kind contributions Major In-Kind Supporters Industry Supporters

4. Published in Australia by The International Association of Contact Lens Educators  First Edition 1997   The International Association of Contact Lens Educators 1996 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission, in writing, of:  The International Association of Contact Lens Educators IACLE Secretariat, PO Box 656 Kensington NSW 1465 Australia  Email: [email protected]

5. CONTRIBUTORS Lens Dispensing and Patient Education: Ma. Meredith Reyes, OD, MA Robert Terry, BOptom , MSc Lewis Williams, AQIT ( Optom ), MOptom , PhD Desmond Fonn , Dip Optom , MOptom (Editor-In-Chief) For a complete list of acknowledgements please see our website: www.iacle.org

6. VERIFICATION Laboratory Clinic Patient

7. HYDRATED SCL TOLERANCES BCOR: ±0.20 mm BOZR: ±0.20 mm (wet cell) ±0.10 mm (dehydrated) BPOR: ±0.20 mm BVP: ±0.25 D (+10.00 to -10.00 D) FCOD: ±0.20 mm TD: ±0.20 mm t c and t EA : ±0.03 mm Room temperature: 20 ± 0.5°C Hydrating solution: 0.9% saline

8. HARD CORNEAL LENS TOLERANCES BCOD: ±0.05 mm (light blend) ±0.10 mm (medium & heavy blend) BOZR: ±0.02 mm BPCD: ±0.05 mm BPR: ±0.10 mm BVP: ±0.12 D (+10.00 to -10.00 D) ±0.25 D (>10.00 D) FCOD: ±0.10 mm TD: ±0.05 mm t c and t EA : ±0.02 mm

9. STORAGE AND LABELLING Use proper lens cases Label cases and boxes prior to dispensing Use proper storage or disinfecting solution to ensure hydration

10. STORAGE AND LABELLING

11. STORAGE AND LABELLING

12. EFFECTS OF HYDRATION RGP hydration flattens BOZR Dehydration-hydration changes are smaller for low water SCLs Linear relationship between refractive index and water content

13. RESPONSIBLITIES OF THE PRACTITIONER At the dispensing visit: Contact lenses Good vision Contact lens fitting Care and maintenance instruction

14. VISION ASSESSMENT During the dispensing visit: Assess visual acuity before and after over-refraction

15. FITTING ASSESSMENT Static and dynamic fitting Surface wettability and lens quality Corneal integrity

16. Patient education and instruction is a continuous process

17. FACTORS TO CONSIDER IN PATIENT INSTRUCTION Care regimen suitable for the patient Age and gender Intelligence of the patient Type of contact lenses dispensed Occupational and visual demands Environmental exposure Temporary conditions

18. FACTORS TO CONSIDER IN PATIENT INSTRUCTION

19. FACTORS TO CONSIDER IN PATIENT INSTRUCTION

20. The clinical assistant provides support services and is a valuable resource in the practice

21. CLINICAL ASSISTANTS Delegate: History taking Keratometry Autorefactometry Visual fields Teaching of CL insertion and removal

22. CLINICAL ASSISTANTS

23. CLINICAL ASSISTANTS

24. CLINICAL ASSISTANTS

25. TEACHING LENS HANDLING TECHNIQUES Insertion and removal Storage and removal from the case Rub and rinse process Accidental lens ejection and displacement Emergency lens removal

26. TEACHING LENS HANDLING TECHNIQUES

27. TEACHING LENS HANDLING TECHNIQUES

28. TEACHING LENS HANDLING TECHNIQUES

29. TEACHING THE USE OF SOLUTIONS Patient-specific care regimen Simplify instruction Demonstration, referral sheet/checklist Provide instruction to family member

30. TEACHING THE USE OF SOLUTIONS

31. TEACHING CARE OF THE LENS CASE Provide samples of different lens cases Lens replacement schedule and cleaning instructions Note visual clues as to the standard of care Illustrate graphically risks of non-compliance

32. TEACHING CARE OF THE LENS CASE

33. MINIMISING THE RISKS OF FORGETTING INSTRUCTIONS Aids: - videotapes - illustrations and printed notes - checklist - labels - schedules Repetition Reinforcement

34. UNDERSTANDING WEAR MODALITY Explain that individual patients require different wear modalities

35. ADAPTATION PERIOD Lens wear Vision care Maintenance routine

36. FOLLOW-UP AND AFTER-CARE SCHEDULE Important for: Eye health care Patient management Monitoring patients

37. FOLLOW-UP AND AFTER-CARE SCHEDULE

38. ADAPTIVE SYMPTOMS Most obvious in neophyte wearers Will occur in drop-outs when refitted Can occur in occasional wearers Greater with rigid lenses Usually only some, not all, reported Usually only occur in very early stages of wear

39. ADAPTIVE SYMPTOMS Presence of the lenses (FB sensation) Perturbations of ocular and lid physiology - hypoxia - hypotonic tears Retinal sensory reflex Psychological? AETIOLOGY

40. ADAPTIVE SYMPTOMS Tearing Lid irritation Difficulty looking up Occasional blurring/disturbances of vision Reduced inclination to make extreme eye movements Abnormal head posture

41. ADAPTIVE SYMPTOMS Excessive blinking Photophobia Headache Lens loss or displacement Tiredness

42. ADAPTATION: OTHER Endothelial Bleb Response in Extended Wear: Decreases progressively Almost imperceptacle after 7 days/nights

43. ADAPTIVE SYMPTOMS Persistent - pain - haze - haloes Significant hyperaemia ‘Spectacle blur’ beyond 1 - 2 hours ABNORMAL

44. NON-ADAPTIVE SYMPTOMS Some lens awareness Some ‘dryness’ Slight redness Explicable vision reduction (e.g. no cylinder) Some ‘spectacle blur’

45. THANK YOU Table of Contents 14 Feedback on errors, omissions, or suggestions for improvement are invited. Please contact us at: [email protected] See the following slides explaining the symbols, abbreviations, and acronyms used in the IACLE Contact Lens Course

46. SYMBOLS

47. ABBREVIATIONS

48. ACRONYMS

49. ACRONYMS