Ординатура / Офтальмология / Английские материалы / Medical Contact Lens Practice_Millis_2005

A

abrasions, corneal scleral lenses 124 staining 51 TCLs 131

absorption, therapeutics 137–8 Acanthamoeba keratitis 66, 70–2

anti-acanthamoebic drugs 142–3 acyclovir 143

adenoviral conjunctivitis 96–7 adherence, lens, EW 88 aftercare, EW 91–2

aging

bifocal contact lenses 39–41 characteristics 36–7

contact lens correction 37–41 corneal edema 37

eyelids 36 monovision 37–9

older patients, evaluation 35–42 presbyopia 37–8, 41

TBUT 37

tear films 36–7

air bubbles, staining 50 allergic conjunctivitis 77–8, 97 allergic eye 75–82

anaphylaxis 76–7 anti-allergy treatment 144–5

atopic keratoconjunctivitis 80–1 contact dermatoblepharitis 81 hypersensitivity 75–7 IgE-mediated (type I)

hypersensitivity 76

immune response modification 80 ocular allergy 77–81

ocular disease 76

T cell-mediated (type IV) hypersensitivity 76–7

vernal keratoconjunctivitis 80, 81

C

cancer, eyelids 33

care systems 91–2, 124, 127, 149–56, 160 antimicrobials 153

disinfection 152–3, 154–5 handwashing 149

hydrogen peroxide systems 152–3 lens care 149–56

non-hydrogen peroxide systems 153 rinsing solutions 154

Caroline technique, fitting contact lenses 8–12

cataract, corticosteroids 144

CD lenses, bifocal contact lenses 40–1 cephalosporins 141

chalazia, eyelids 32

chlamydial infection, conjunctivitis 96 chloramphenicol 140–1

choice, lens, factors affecting 2 cicatricial pemphigoid 22 ciprofloxacin 141–2

CLARE see contact lens acute red eye cleaning see care systems

clinical records 157–61 aids 157 confidentiality 159 consultations 160–1

general information 158 good records 157 informed consent 159–60 instruction leaflets 158–9 letters 159

mailing lenses 161 maintaining records 159

practitioner–patient relationship 159 problem-orientated records 158 record data 158

telephone calls 158

clinical slit lamp, photography 12 closed eye 83–5

corneal edema 84–5 hypoxia 83–4

see also extended wear CLPU see contact lens-related

peripheral ulcer

CLRMK see contact lens-related microbial keratitis

CLRPC see contact lens-related papillary conjunctivitis

CN lenses, bifocal contact lenses 40–1 collagen shields

TCLs 133 therapeutics 139

coloboma 3 color maps

astigmatism 6 VKS 5–8

color matching painted lenses, prosthetic lenses 126–7

compliance, therapeutics 140 complications 43–59

astigmatism, residual 46 avoiding 58–9

blurred vision 43–6 burning sensation 46 CLARE 58

corneal edema 43–4

corneal exhaustion syndrome 54–5 damage, lens 45, 51–2

deposit formation 52–4 dirty lenses 45 discomfort 46

EW 87–90 fit, lens 45–6 flare 46–7 glare 46–7

incorrect lenses 44 lens-related problems 51–4 loss, lens 47–8

motivation 57–8 noncompliance 58 pain 46

patient-related problems 57–8 photophobia 47

ruckling 47 signs 44, 48–57 spoilation 52–4 staining 48–51 symptoms 43–8

vascularization 55–7 watering eyes 46

concentric, simultaneous vision lenses 40–1

cone, keratoconus 104–5 confidentiality 159 conjunctivitis

adenoviral 96–7 allergic 77–8, 97 bacterial 96 chlamydial infection 96 features 95–6

GPC 53, 54, 78–80, 124 papillary conjunctivitis 53, 54 pinguecula 97–8

pterygium 98 red eye 95–8

superior limbic keratoconjunctivitis 97

thimerosal sensitivity 97 viral 96–7

conservation, dry eye 26 consultations 160–1

contact dermatoblepharitis 81

contact lens acute red eye (CLARE) 58 contact lens-related acute red eye,

EW 89

contact lens-related microbial keratitis (CLRMK) 61–74

Acanthamoeba keratitis 66, 70–2 clinical features 69–70

corneal alterations 64–5 endothelium changes 64–5 epithelial changes 64, 68–9 etiology 64–5

EW 89

host response 68–9 hypoxia 65 immunity 61–4 investigations 72 management 72 pathogenicity 66–9

protection, ocular surface 61–4 restarting lens wear 72

risk factors 65–6 stromal changes 64 tissue damage 66–9 treatment 72

ulcer formation 69 virulence 66–7

contact lens-related papillary conjunctivitis (CLRPC) 78–80

contact lens-related peripheral ulcer (CLPU), EW 90

corneal abrasions scleral lenses 124 staining 51 TCLs 131

corneal alterations, CLRMK 64–5 corneal desiccation, staining 48–9 corneal edema

aging 37 closed eye 84–5

complications 43–4 EW 84–5

corneal epithelial dystrophies, TCLs 130 corneal erosions, recurrent, TCLs 130–1 corneal exhaustion syndrome 54–5 corneal infiltrates, EW 88–9

corneal inflammation 98–101 corneal sensation 65

corneal staining, keratoconus 108 corneal topography 3–8

keratometry 3–4 patterns 6–8 photokeratoscopy 4 VKS 4–8

corneal vascularization EW 88

see also vascularization corticosteroids 80, 143–4

cataract 144

raised intraocular pressure 144 viral keratitis 99

cranial nerve palsy, TCLs 131 cyclopentolate hydrochloride 145

D

damage, lens, complications 45, 51–2 deposit formation

blinking 54 design, lens 54

environmental drying conditions 54 EW 88

factors affecting 53–4 GPC 53, 54

ionicity 53 “jelly bumps” 53

manufacturing technique 53 mechanism 52–4 medication 54

modality of wear 54 papillary conjunctivitis 53, 54 sulphur 54

types 53

water content 53 dermatochalasis, eyelids 31 Descemet’s membrane, keratoconus

105–6

design, lens, deposit formation 54 digital imaging, photography 13–14 dirty lenses, complications 45 discomfort

complications 46 keratoconus 108 disinfection 152–3, 154–5 see also care systems

displacement, EW 88 distichiasis, eyelashes 31 distribution, therapeutics 138 drops

therapeutics 138–9, 140 wetting drops 147–8

drug delivery TCLs 132

see also therapeutics dry eye 18–27

aqueous tear flow 20 blepharitis 23–4 blinking 24–5 causes 22 classification 19 CLRMK 65, 66 conservation 26

contact lens wear 24–7 defined 18–21 development 26 diagnosis 19–21 evaporative 24–5 eyelid abnormalities 24

grading surface damage 19 hyperosmolarity 26 lubrication 26–7

phenol red thread test 20

preservatives 26 Schirmer’s test 20 stains 19 symptoms 18–19 TBUT 19–21

see also tear films

E

ectropion, eyelids 30–1 edema see corneal edema emedastine 145 endothelium changes

CLRMK 64–5 hypoxia 84

entropion, eyelids 30 environmental drying conditions

deposit formation 54 staining 49

enzyme cleaners 151–2 episcleritis 100 epithelial changes

CLRMK 64, 68–9 hypoxia 84 PEDs 131

TCLs 131

epithelial healing, TCLs 130–1 erosions, recurrent corneal, TCLs 130–1 evaluation, older patients 35–42 evaporative dry eye 24–5

EW see extended wear examination

corneal topography 3–8 EW 86–7

follow-up 14–15 history 1–2 patients 1–12

excretion, therapeutics 138 extended wear (EW) 83–93

adherence, lens 88 aftercare 91–2 anesthetics 88 bacterial infection 85 blurred vision 87–8 closed eye 83–5 CLPU 90

CLRMK 89 complications 87–90

contact lens-related acute red eye 89 corneal edema 84–5

corneal infiltrates 88–9 corneal vascularization 88 deposit formation 88 displacement 88 examination 86–7

fitting contact lenses 86–7 hypoxia 83–4

loss, lens 88

patient information 91 patient selection 85–6

Pseudomonas aeruginosa 85 SEAL 91

silicone hydrogel lenses 90–1 soft lenses 86–7 subepithelial infiltrates 88–9 tear films 85

therapeutic uses 91 eyelashes 29–33

abnormalities 31 distichiasis 31 trichiasis 31

eyelids 29–33 abnormalities, dry eye 24 aging 36

blepharitis 31 blinking 30 cancer 33 chalazia 32

dermatochalasis 31 disorders 31–2 distorted 30–1 ectropion 30–1 entropion 30 ptosis 31

styes 31–2 tension 30 tumors 32–3

F

family history, patients 2 filamentary keratitis, TCLs 130 fit, lens, complications 45–6 fitting contact lenses

astigmatism 10–12 Caroline technique 8–12 EW 86–7

postsurgical 112–14 tear films 8–12 VKS 8–12

fitting scleral lenses 123 fitting TCLs 133

flare, complications 46–7 Fleischer’s ring, keratoconus 105 fluorescein stain 147

dry eye 19, 20 fluoroquinolones 141–2 follow-up examination 14–15 foreign body staining 49 fornices, TCLs 132

fusidic acid 142

G

gels, therapeutics 139 gentamicin 141

therapeutic contact lenses (TCLs) 129–35

band keratopathy 130 bilateral corneal abrasions 131 bullous keratopathy 129–30 collagen shields 133 complications 134 contraindications 134

corneal abrasions 131

corneal epithelial dystrophies 130 cranial nerve palsy 131

drug delivery 132 epithelial changes 131 epithelial healing 130–1 filamentary keratitis 130 fitting 133

fornices 132 hydration 131 hydrogel lenses 132 lacerations 132

lens selection 132–3 management 133 medication 134 molding 132

pain relief 129–30 PEDs 131 perforations 132 postsurgical 131–2 protection 131–2 ptosis 132

recurrent corneal erosions 130–1 Reis–Buckler’s corneal dystrophy

131

RGP lenses 132–3 risk minimization 134

silicone rubber lenses 133 splinting 132

superior limbic keratoconjunctivitis 130

Thygeson’s superficial punctate keratitis 130

therapeutic uses EW 91

scleral lenses 122

silicone hydrogel lenses 91 therapeutics 137–48

absorption 137–8 acyclovir 143 amethocaine 146

aminoglycoside antibiotics 141 anti-acanthamoebic drugs 142–3 anti-allergy treatment 144–5 anti-infective drugs 140–3 anti-inflammatory drugs 143–5 antibiotics 140–2

antihistamines 80, 145 antivirals 143 atropine 146 azelatine 145

cephalosporins 141 chloramphenicol 140–1 ciprofloxacin 141–2 collagen shields 139 compliance 140 corticosteroids 143–4

cyclopentolate hydrochloride 145 distribution 138

drops 138–9, 140

drug delivery, TCLs 132 drug delivery vehicles 138–9 emedastine 145

excretion 138 fluoroquinolones 141–2 fusidic acid 142

gels 139 gentamicin 141 levocabastine 145 lignocaine 146 lodoxamide 144 lubricants 147–8

mast cell stabilizers 80, 144 mechanisms of action 140 metabolism 138 mydriatics 145–6 nedocromil 144

neomycin 141 nomenclature 138 NSAIDs 144

ocular decongestants 145 ofloxacin 142

ointments 139

olopatidine (Opatanol®) 145 Otrivine Antistin® 145 oxybuprocaine 146 pharmacokinetics 137–40 polyhexamethylene biguanide 143 prodrug 139

propamidine isethionate 143 proxymetacaine 146

sodium cromoglycate 144 soft contact lenses 139 tetracyclines 142 tobramycin 141

topical anesthetics 146 trifluorothymidine (F3T) 143 tropicamide 146

vehicles, drug delivery 138–9 vital dyes 147

wetting drops 147–8

thimerosal sensitivity, conjunctivitis 97 three and nine o’clock staining 48–9 Thygeson’s superficial punctate

keratitis, TCLs 130 tight lens fit, staining 49–50 tisilfocon RGP lenses 91 tobramycin 141

tonometers, disinfection 154–5 topical anesthetics 146

complications 146 topography, corneal see corneal

topography toxic staining 50–1

translating (alternating) bifocals 39–40 trapped air bubbles, staining 50 trichiasis, eyelashes 31 trifluorothymidine (F3T) 143 tropicamide 146

tumors, eyelids 32–3

U

uveitis, red eye 101

V

vascularization causes 55

complications 55–7 EW 88 management 55–7

neovascularization 124 scleral lenses 124

vehicles, drug delivery 138–9 ventilation, scleral lenses 123 vernal keratoconjunctivitis 80, 81 videokeratoscopy (VKS) 4–12

color maps 5–8

corneal topography 4–8 fitting contact lenses 8–12 projection-based systems 5–8 rasterstereography 5 reflection-based systems 4–5

viral conjunctivitis 96–7 antivirals 143

viral keratitis 99–100

visual acuity, keratoconus 104 vital dyes 147

VKS see videokeratoscopy Vogt’s striae, keratoconus 105

W

water content, deposit formation 53 water, tap, CLRMK 66

watering eyes complications 46 lacrimal system 32

wetting drops 147–8

X

xanthelasma, eyelids 33