Lite preservative
polyhexanide
Complete preservative
PHMB
OptiFree Express preservative
polyquad and Aldox
OptiFree RepleniSH preservative
Polyquad and Aldox
ReNu Advanced Formula preservative
PAPB, Polyquad, and Alexidine
Biotrue preservative
PAPB and polyquad
OptiFree PureMoist preservative
Polyquad and Aldox
Acuvue Revitalens preservative
polyquad and alexidine
ClearCare Preservative
peroxide and surfactant
Oxysept Preservative
peroxide
Refine 1 Step preservative
peroxide
Menicare GP-CDS preservative
Benzyl alcohol
Optimum preservative
benzyl alcohol
Unique pH preservative
polyquad
Boston Simplus preservative
PHMB and chlorhexidine
Boston Advance preservative
PHMB
Boston Original preservative
chlorhexidine
Supraclens (enzyme cleaner) can be added with...
Optifree Express, OptiFree RepleniSH, Unique pH
GP care systems with separate wetting drop (cannot be used directly in the eye)
Menicare GP-CDS, Optimum
GP 1 bottle systems (Disinfectant, wetting, cleaning/surfactant all in one bottle)
Unique pH, Boston Simplus
GP wetting/disinfectant with separate (abrasive) cleaner
Boston Advance, Boston Original
Soft lens surfactant cleaners (with abrasive beads)
Miraflow, OptiFree Daily Cleaner
Chemical care systems effective against acanthamoeba (soft lenses)
Biotrue, OptiFree PureMoist, Acuvue Revitalens
Biotrue description
matches pH of the tears and uses hyaluranon (lubricant found in the eyes), keeps beneficial tear proteins active
OptiFree PureMoist description
envelops lens in moisture (hydraglyde moisture matrix) and sticks to the lens and wets it from insertion to removal
Acuvue RevitaLens description
peroxide quality disinfectant (30 day efficacy without lid, effective against both forms of acanthamoeba)
preservative sensitivity symptoms
redness, itching, burning, dryness, lens intolerance, decreased wear time
Oxysept steps
use tablets in peroxide solution (turns pink when neutralized); can use ultrasound enzyme if needed, sterile saline used to rinse
Refine Cooper 1 step
use neutralized solution for wetting
Clear Care steps
use neutrliazed solution for wetting
PHMB/PAPB/Polyhexanide/Dymed
effective against Serratia Marcescens
Polyquad/polyquaternium
similar to BAK without adverse effects
Chlorhexidine
no longer used in soft solutions (reactions less in GP lenses)
Benzyl alcohol
cannot be used in the eye
thimerosal
rarely used in CL solutions due to high rate of sensitivity
BAK
commonly used in ophthalmic solutions, effective against bacteria and fungi (high concentrations can cause dryness/SPK)
EDTA/ethylene diamond tetraacetate
not a true preservative, but combined with others to enhance action against pseudomonas
In office GP cleaners
Boston laboratory cleaner/polishing compound, menicon progent
enzymatic cleaners for GP lenses
supraclens, Boston 1 step, Menicon Progent
medical history to note for CL preliminary evaluation
allergy/sinusitis, dryness of mouth/eyes/mucous membranes, convulsions/epilepsy/fainting spells, diabetes, pregnancy, psychiatric treatment, thyroid imbalance, smoking, medications
HVID
horizontal visible iris diameter
corneal diameter (10-13 mm) used to determine diameter of CL
pupil diameter
in dim and normal illumination (dim for determining optical zone diameter of GP lens)
small: <5mm
medium: 5-7mm
large: >7mm
palpebral aperture heigh
vertical measurement of the opening between the upper and lower limbs with patient gazing straight ahead
helps determine type of lens and lens diameter for optimum patient comfort
large: >12mm
small: <9mm
residual cyl with soft lens
equals the REFRACTIVE cyl
residual cyl with GP lens
equals the refractive cyl � corneal cyl (k values)
myopes will have ________ vergence demand in Contact Lenses over specs
increased (has to converge more because they don't have the BI prismatic effect without specs)
hyperopes will have _______ vergence demand in Contact lenses over specs
decreased (has to converge less because they don't have to fight against the BO prismatic effect without specs)
normal TBUT
15-20 seconds (<8-10 may indicate dry eye)
normal Schirmer Tear test
1 minute ? 6 mm
5 minutes ? 15mm (9-14 is mild dryness)
normal phenol red thread test
15 seconds ? 24 mm (<9mm=dry eye)
good contact lens candidates
aphakes, high myopia, hyperopia, refractive anisometropia, keratoconus, motivated, good eye health
poor contact lens candidates
unmotivated, dry eye, moderate allergies/antihistamine use, GPC/coalesced staining, active infection, dirty, pregnant, BV issues