Quiz For The Signs Point to a Change

Two significant developments in the field of soft lenses have enhanced the clinicians tools for solving soft lens problems. These are:

The development of PMMA lenses

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The development of modern disposable lenses

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The development of segment style GP lenses

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The development of progressive addition lenses

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During the 1990s _____________ became the modality of choice for the majority of first time wearers.

disposable contact lenses

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cylindrical soft lenses

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RGP bitorics

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prism ballast

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In the 1990s the emergence of silicone hydrogel lenses addressed a major problem not solved by the initial generation of hydrogel disposable lenses. This was:

improved oxygen transmission

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patient compliance

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vertical striae

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heat disinfection

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A grading scale may be used:

to evaluate changes in the various conditions as outlined in this course

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to determine the expertise of the contact lens fitter

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to determine the motivation of a patient

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to analyze the size of lens chips

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The use of fluorescein:

can be an effective method of monitoring alterations in corneal integrity secondary to contact lens wear

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can be used only with HEMA lenses

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should never be used with rigid lens materials

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might permanently stain a PMMA lens

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The introduction of ______________ and its ability to be used with a soft lens in the eye has helped to increase the use of fluorescein as a diagnostic tool.

high molecular weight fluorescein (fluorexon)

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low molecular weight fluorescein

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all-in-one soaking solution

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enzymatic cleaner

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The configuration of corneal punctate staining may be used to identify:

all lens parameters

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peripheral lens width

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visible iris diameter

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oxygen deprivation

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________________can arise from excessive pressure on the cornea from the contact lens.

Mechanical trauma

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Solution sensitivity

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Lack of desiccation

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Excessive tear production

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________________ of the lens represent the most common areas of bearing

the center and edge

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the 3 o'clock and 9 o'clock areas

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the optical center

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the anterior surface

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Isolated areas of staining can occur as the result of:

nicks and tears in a lens

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rewetting solution overuse

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normal evaluation exam

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good lens fit

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________________ may be secondary to a foreign body stain.

Linear corneal staining

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Lissamine green intolerance

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Solution use as prescribed

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Adequate lens centration

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Lens deposits as well as trapped epithelial debris may result in:

linear corneal staining

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solution sensitivity staining

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lens nicks and tears

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scattered punctate staining

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________________ may also be a source of punctate staining in hydrogel lens patients.

Lens dehydration

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Optimal solution pH

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Use of rewetting solution

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Following prescribed wearing schedule

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Incomplete lid closure when blinking may result in:

inferior punctate staining

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solution sensitivity

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lens nicks and tears

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adequate tear replenishment

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_______________ may develop as the result of solution sensitivity.

superficial punctate staining

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lens nicks and tears

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incomplete blinking

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corneal compression

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Clinical signs of corneal edema secondary to hydrogel lens wear:

are apparent only in severe cases

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occur with almost all soft lens fittings

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are nothing to be concerned about

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are apparent only in lenses with high minus power

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The use of silicone hydrogel lenses for daily wear or overnight wear has virtually __________ corneal hypoxia in most patients

doubled

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eliminated

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tripled

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quadrupled

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Epithelial microycysts are a complication found with:

daily wear lenses

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extended wear hydrogel lenses

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both daily wear and extended wear hydrogel lenses

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daily disposable

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The current standard of care for managing patients with hydrogel lens-induced corneal edema is:

to re-fit them with RGP Lenses

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to re-fit them with keratoconus lenses

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to re-fit them in silicone hydrogel lenses

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this patient is not a good candidate for contact lenses

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A lens with minimal or no lens movement on the cornea may result in:

edema of the inferior lid

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conjunctival injection

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mixed astigmatism

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a torn lens

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Which of the following can cause conjunctival injection related to contact lens wear?

A well centered lens

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A lens without deposits

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A poor fitting lens

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Lack of sleep

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Which of the following causes of conjunctival injection is most likely related to contact lens wear?

Seasonal allergies

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Lack of sleep

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Solution sensitivity

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Dry atmosphere

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The cause of injection related to contact lens use can be limited if based upon:

A verbal discussion only

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A nomogram only

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The lens literature from a manufacturer only

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The lens to cornea fitting relationship

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Immediate injection with burning on insertion is most likely related to:

solution sensitivity

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intraocular abnormalities

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long term conjunctivitis

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blunt trauma

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As the wearing time increases over the period of a day with DW or over the period of days with EW , corneal hypoxia, a tight or damaged lens may result in:

conjunctivitis

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a contaminated lens

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generalized injection

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eyelash loss

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CLARE:

is of little concern

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is characterized by an EW patient awakening with a refreshed looking eye

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is an anagram for contact lens acquired remedy

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is an inflammatory reaction that occurs with overnight wear of soft contact lenses

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The presence of a vascular response to contact lens wear is can be caused by:

a well centered lens

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a clean lens

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adequate oxygenation

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excessive wear by the patient

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One of the most effective means of controlling vascularization is through fitting the patient with ____________ lenses.

PMMA

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silicone hydrogel

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tight fitting

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bitoric

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The following symptoms describe ________ GPC. Minimal mucus; moderate itching; slight lens awareness; slight decrease in vision through the lens.

stage 1

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stage 2

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stage 3

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stage 4

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Contact lens-induced Giant Papillary Conjunctivitis:

is only associated with RGP lens wearers

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can be due to patient adherence to prescribed schedule and procedures

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is only seen with young contact lens wearers

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is a complication affecting both soft and rigid contact lens wearers

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One step, multipurpose solutions may enhance compliance if:

the solutions can only be purchased in the prescribing doctor's office

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patients find that the instructions are easy and convenient to follow

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the solutions expire exactly every thirty days

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patients can safely reuse the same solution in the lens case for several days

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The FDA recently recommended:

that all patients wear disposable lenses

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that RGP lenses be dispensed along with a soft lens supply

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that lenses approved for 30-day wear might be safer with a shorter wearing schedule

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that all lenses must be discarded at the end of the month

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SEAL stands for:

simple everyday aligned lenses

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superior edge arcuate lens

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superior epithelial arcuate lesions

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staining each allowed lens

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Daily surfactant or weekly enzyme cleaning may be required in order to:

replenish the moisture in a lens

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remove lens deposits

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keep a lens from ripping

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avoid lens loss

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Placing a hydrogel lens on the eye results in:

loss of vision

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a painful response

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a decrease in the amount of oxygen available

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redness of the eye

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Compared to that of a GP contact lens, the exchange of new tears under the soft lens is:

minimal

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excessive

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absent

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unwarranted

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How does a patient describe injection:

tears overflowing on to the cheek

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itching

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redness

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dragging lens

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What is considered a solution free lens?

A hydrogel lens

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A silicone hydrogel lens

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A HEMA lens

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A daily disposable lens

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After removing a damaged lens, what should the lens fitter do?

Recommend a new brand of lenses

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Evaluate the cornea to ensure it was not affected

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Immediately dispense daily disposable lenses

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Re-fit the patient with an RGP lens

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Injection located in a specific area of the eye usually:

indicates an overall tight lens fit

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signals the beginning of a hordoleum

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signals an irritation of that specific area

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means the patient is allergic to a solution

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