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Working With
Contacts: The
Technician’s
RolePresented by Amy Saxton,COT
Disclosure
Unfortunately, no one pays me!
Contacts SchmontactsWhat 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 ContactsSoft 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
MultifocalsAn emerging technology
MultifocalsAn emerging technology
Determine dominant eye
Choose lens design – let the doctor and experience guide you!
MultifocalsAn 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