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    Adaptive Symptoms of RGP PDF

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    anggastavasthi
    This document discusses contact lens adaptation and differentiating normal adaptive symptoms from abnormal symptoms. It notes that physiological adaptation includes changes to tear composition and neurological adaptation decreases corneal sensitivity. Normal adaptive symptoms are expected in the first 2-4 weeks of wear and include mild sensitivity, dryness, tearing, headache, and fluctuating vision. These diminish over time with continued wear. Abnormal symptoms are severe, persistent beyond the expected period, or have an identifiable physical cause. Successful adaptation involves educating patients, gradually increasing wearing time each day according to a schedule, and being aware that mild redness and tearing can occur towards the end of the wearing period.

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    Adaptive Symptoms of RGP PDF

    Uploaded by

    anggastavasthi
    373 views9 pages
    This document discusses contact lens adaptation and differentiating normal adaptive symptoms from abnormal symptoms. It notes that physiological adaptation includes changes to tear composition and neurological adaptation decreases corneal sensitivity. Normal adaptive symptoms are expected in the first 2-4 weeks of wear and include mild sensitivity, dryness, tearing, headache, and fluctuating vision. These diminish over time with continued wear. Abnormal symptoms are severe, persistent beyond the expected period, or have an identifiable physical cause. Successful adaptation involves educating patients, gradually increasing wearing time each day according to a schedule, and being aware that mild redness and tearing can occur towards the end of the wearing period.

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    This document discusses contact lens adaptation and differentiating normal adaptive symptoms from abnormal symptoms. It notes that physiological adaptation includes changes to tear composition and neurological adaptation decreases corneal sensitivity. Normal adaptive symptoms are expected in the first 2-4 weeks of wear and include mild sensitivity, dryness, tearing, headache, and fluctuating vision. These diminish over time with continued wear. Abnormal symptoms are severe, persistent beyond the expected period, or have an identifiable physical cause. Successful adaptation involves educating patients, gradually increasing wearing time each day according to a schedule, and being aware that mild redness and tearing can occur towards the end of the wearing period.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    373 views9 pages

    Adaptive Symptoms of RGP PDF

    Uploaded by

    anggastavasthi
    This document discusses contact lens adaptation and differentiating normal adaptive symptoms from abnormal symptoms. It notes that physiological adaptation includes changes to tear composition and neurological adaptation decreases corneal sensitivity. Normal adaptive symptoms are expected in the first 2-4 weeks of wear and include mild sensitivity, dryness, tearing, headache, and fluctuating vision. These diminish over time with continued wear. Abnormal symptoms are severe, persistent beyond the expected period, or have an identifiable physical cause. Successful adaptation involves educating patients, gradually increasing wearing time each day according to a schedule, and being aware that mild redness and tearing can occur towards the end of the wearing period.

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    of 9

    Pertemuan Ilmiah Tahunan Perdami ke-40

    Adaptive Symptoms of RGP


    Dr. Christina A, SpM
    RSUD Dr. Soetomo - Fk. Unair Surabaya

    Types of CL Adaptation
    A. Physiological
    B. Neurological
    CL Adaptation
    A. Physiological:

    Lacrimation contributes to 3% corneal

    Altered tear protein levels, NaCl and K ions affect equilibrium of tear
    layer (Gildos-Donnan)

    Tear layer becomes diluted of proteins and ions (ie. hypotonic)

    B. Neurological:

    Corneal sensitivity decreases with lens wear

    As the Dk of the material decreases, the corneal thickness increases and


    the corneal sensitivity decreases (Millidot)

    Neural adaptation coincides with CL adaptation (Lowther and Hill)

    CL Adaptation versus Abnormal Symptoms:


    Adaptive Symptoms:

    expected during the first 2-4 weeks of wear

    diminishes with each day

    Abnormal Symptoms:

    persist beyond the expected period

    due to an identifiable physical cause

    lens /solution related

    procedural errors

    environment related

    Trans Luxury Hotel,


    Bandung, 13-15 Agustus 2015

    Pertemuan Ilmiah Tahunan Perdami ke-40

    NORMAL ADAPTIVE SYMPTOMS occur:

    * Normal ocular response for the first couple of weeks


    * in drop-outs when refitted
    * in occasional wearers
    * Greater with rigid lenses
    * Usually only some, not all, reported
    * Usually only in very early stages of wear
    NORMAL ADAPTIVE SYMPTOM (diminish gradually):

    Mild sensitivity to light as extra sensitivity to wind,smoke,dust

    Slight headache

    Tearing- foreign body sensation

    Dryness

    Increases blinking

    Difficulty looking up and to side

    Abnormal head posture

    Palpebral aperture narrowing

    Itchiness of lids and eyes after removal

    Photophobia

    mild redness at the end of wearing period. It is common for patient


    with allergies or chronic sinus problems.

    fluctuating vision

    halo or flare at night, reflections, fluttering of light, haze

    lid swelling

    mild blur after each blink excess tears

    mild discomfort or irritation cause lense contact with the upper lid on
    upward gaze

    lens/eye dry at the end of wearing time

    Trans Luxury Hotel,


    Bandung, 13-15 Agustus 2015

    Pertemuan Ilmiah Tahunan Perdami ke-40

    Spectacle blur after the removing the CLs should not last over 15 20
    minutes good central corneal response

    Abnormal Symptoms ( Sudden):

    Sudden pain/burning during and after CL wear

    Excessive tearing

    Severe redness / irritation that does not clear up

    Severe/ persistent halo around lights

    Blur with specs > 1 hour after removal

    Increasing discharge or mattering

    Lens adhering to eye

    At any time occur should remove the lenses

    Abnormal Symptoms ( Persistent):

    Vision reduction/fluctuation

    Discomfort/pain

    Dryness

    Redness

    Abnormal Symptoms: Vision


    Immediate

    constant :
    improper refraction
    significant uncorrected astigmatism
    poor optics
    inverted lens
    lens switched
    lens surface defects/scratches

    intermittent/fluctuate :

    loose fit

    optic zone not centred

    optic zone too small/ only in dark

    Trans Luxury Hotel,


    Bandung, 13-15 Agustus 2015

    Pertemuan Ilmiah Tahunan Perdami ke-40

    dry environment

    dry eyes

    improper/incomplete blink

    Delayed

    becomes worse :
    flat/steep fit (punctate staining)
    excessive/minimum lens movement
    mechanical trauma to cornea
    poor tear circulation
    change in lens parameters/warpage
    deposits
    discolouration

    fluctuate :
    excessive secretions
    incorrect lens bearing
    secretion with bad lens edge
    BV anomaly/accommodation

    Spectacle Blur (GP) :


    <1 hour
    low DK causing corneal warpage
    modify lens edge
    modify lens parameters
    change lens power
    change lens design
    give BV training
    clean/polish lens
    go to disposable lens

    Reduced Vision with GP


    flexure
    Trans Luxury Hotel,
    Bandung, 13-15 Agustus 2015

    Pertemuan Ilmiah Tahunan Perdami ke-40

    warpage
    decentration
    poor surface wettability
    power change
    Flexure: Causes
    high astigmatism
    steep BOZR
    thin design
    large BOZD
    Flexure: Diagnosis
    toricity with over-K
    spherical on radiuscope
    Warpage: Causes
    digital pressure when cleaning
    former PMMA wearer
    improper placement in case
    Warpage: Diagnosis
    toric values with radiuscope
    Decentration: Causes
    decentered apex
    unusual corneal topography
    tight or loose lid tension
    thick lens design
    high specific gravity material
    Decentration: Diagnosis
    biomicroscopic evaluation during & after the blink
    Poor Surface Wettability: Causes
    Initial
    too much heat during manufacturing
    Trans Luxury Hotel,
    Bandung, 13-15 Agustus 2015

    Pertemuan Ilmiah Tahunan Perdami ke-40

    poor polishing techniques


    improper diamond
    residual pitch
    Poor Surface Wettability: Causes
    Acquired
    poor tear quality
    improper blinking
    poor compliance
    improper solution
    hand creams, cosmetics
    scratches
    Poor Surface Wettability: Diagnosis
    poor surface wettability;
    break-up of tears
    presence of hazy or mucoprotein deposits
    Power Change: Causes
    aggressive digital cleaning
    use of an abrasive cleaner
    Power Change: Diagnosis
    increase in minus power & or
    decrease in centre thickness during progress visit

    Abnormal Symptoms: Discomfort


    Immediate

    Becomes worse
    loose lens
    excessive movement
    tear, bad edge
    trapped foreign body

    Trans Luxury Hotel,


    Bandung, 13-15 Agustus 2015

    Pertemuan Ilmiah Tahunan Perdami ke-40

    hypersensitive/psychological

    Subsides
    environmental
    smoking
    low humidity
    dirty environment

    Delayed

    Becomes worse
    asthenopia
    residual astigmatism
    accommodation
    BV anomaly

    upon insertion
    after removal
    constant
    immediate (after a period of wear)
    Upon insertion
    torn lens
    solution sensitivity
    prism ballast
    After Removal
    abrasion
    infection
    ulcer
    Constant
    tight lens
    edema
    lens deposits
    Immediate
    Trans Luxury Hotel,
    Bandung, 13-15 Agustus 2015

    Pertemuan Ilmiah Tahunan Perdami ke-40

    trapped FB
    torn lens
    lens deposits
    Leposits
    inverted lens
    abrasion
    defective lens
    edema
    pathology
    Causes of Abnormal Symptoms :

    Refractive - flexure, optics

    Mechanical - edge, fitting, wettability

    Toxic/Allergic - solution

    Hypoxic - Dk, overwear

    Inflammatory - deposits

    Infectious microorganisms

    How to manage adaptation successfully ?

    Tell to the patient about adaptation process

    Some patient to be totally satisfied at 4 weeks

    Increase their wearing time everyday

    Starting off using lens for 3 hours on the first day increasing the
    wearing time by an hour a day.

    RGP lens do not induce more initial awareness than SCL because they are
    rigidfelt more initiallysmaller and move more with the blink.

    Wearing Schedule is as follow :


    Day 1 2 : 4 hours
    Day 3 4 : 6 hours
    Day 5 6 : 8 hours
    Day 7 8 : 10 hours
    Trans Luxury Hotel,
    Bandung, 13-15 Agustus 2015

    Pertemuan Ilmiah Tahunan Perdami ke-40

    Day 9 - ... : full 12 hours wearing


    CONCLUSION

    Adaptive symptoms normally occur during the first 2-4 weeks of wear

    Awareness that increases towards end of wearing period

    Slight redness

    Slight tearing

    Awareness of lens edge > at night

    Halo or flare >at night

    Slight spectacle blur

    Increasing wearing time (follow the wearing schedule) everyday can


    reduce the symptoms

    Trans Luxury Hotel,


    Bandung, 13-15 Agustus 2015

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