Working With Contacts: The Technician’s Role Presented by Amy Saxton,COT
Disclosure Unfortunately, no one pays me!
Contacts Schmontacts What does this have to do with me?! Image courtesy of google images
What Every Tech Should Know About Contacts 1.Basic understanding of types of CL and reasons to go with one modality or another. 2.How to insert and remove CL and how to instruct patient to do so. 3.Appropriate cleaning material and procedure for each modality 4.How to evaluate VA and perform an over-refraction. 5.Basic understanding of evaluation of fit.
Basic understanding of types of CL and reasons to go with one modality or another.
Types of Contacts Soft Contact Lenses - Sphere only, toric, multifocal - variety of replacement schedules: daily, weekly, 2 week, monthly, 3 month, annual - comfortable with variety of lens materials and colors - wide price range to suit most budgets - relatively easy to insert/remove and care for. RGPs – Sphere, toric, multifocal - can last years with careful maintenance - relatively inexpensive - relatively easy to insert/remove and care for - superior optics to soft contacts Hybrids - optics of RGP with comfort of a soft contact Scleral Lenses - comfortable with good optics
Types of Contacts Soft Contact Lenses - Sphere only, toric, multifocal - variety of replacement schedules: daily, weekly, 2 week, monthly, 3 month, annual - comfortable with variety of lens materials and colors - wide price range to suit most budgets - relatively easy to insert/remove and care for. RGPs – Sphere, toric, multifocal - can last years with careful maintenance - relatively inexpensive - relatively easy to insert/remove and care for Hybrids - optics of RGP with comfort of a soft contact Scleral Lenses - comfortable with good optics I CAN’T SEE ANYTHING OW? ARE YOU KIDDING ME?! YOU WANT ME TO DO WHAT?! CHA CHING$$$
Explain the options. Know the Pros and Cons. Let the patient &/or doctor decide.
Insertion and Removal
Caring for the contacts
Achieving the best acuity
YOU HAVE TO KNOW THE PATIENT’S BEST CORRECTED VISUAL ACUITY OR EXPECTED VISUAL POTENTIAL!
Soft Contacts – can use trial frames, push plus All others – use fogging with phoropter Start with just sphere only, however, if that doesn’t reach BCVA then check Cyl/Axis Over- Refraction
Fitting Soft Contact Lens - General Recommendations: Movement: They should move.5-1mm. Comfort counts more than the rule! Generally, as long as movement isn’t past limbus, or if tight that they are free to push, then it’s ok. Excessive movement = flat fit = decrease base curve (steepen) or increase diameter Little to no movement = steep fit= increase base curve (flatten) or decrease diameter Alignment: Let comfort be your guide! Decentered is okay as long as limbus is covered.
Fitting Soft Contact Lens - General Recommendations: Movement: They should move.5-1mm. Comfort counts more than the rule! Generally, as long as movement isn’t past limbus or if tight that they are free to push, then it’s ok. Excessive movement = flat fit = decrease base curve (steepen) or increase diameter Little to no movement = steep fit= increase base curve (flatten) or decrease diameter Alignment: Let comfort be your guide! Decentered is okay as long as limbus is covered. Rotation: Observe where the toric mark lines up.
Fitting Soft Contact Lens - General Recommendations: Movement: They should move.5-1mm. Comfort counts more than the rule! Generally, as long as movement isn’t past limbus or if tight that they are free to push, then it’s ok. Excessive movement = flat fit = decrease base curve (steepen) or increase diameter Little to no movement = steep fit= increase base curve (flatten) or decrease diameter Alignment: Let comfort be your guide! Decentered is okay as long as limbus is covered. Rotation: Observe where the toric mark lines up. LARS – Left Add Right Subtract SAM FAP – Steeper Add Minus Flatter Add Plus
Multifocals An emerging technology
Multifocals An emerging technology Determine dominant eye Choose lens design – let the doctor and experience guide you!
Multifocals An emerging technology Determine dominant eye Choose lens design – let the doctor and experience guide you! Set realistic expectations
Fitting RGPs, Sclerals and Hybrids Know when it’s wrong!
Image courtesy of CLSpectrum