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