Download Is dry eye pain?

CONTROVERSIES & ADVANCES
IN CONTACT LENS CARE
COPE COURSE ID: 27637-CL
JASON J. NICHOLS, OD, MPH, PHD, FAAO (DIPCL)
THE UNIVERSITY OF HOUSTON COLLEGE OF OPTOMETRY
505 J. DAVIS ARMISTEAD BUILDING, HOUSTON, TX 77005
(713) 743-2471
[email protected]
ABSTRACT
The past several years have been filled with new understandings, in addition to controversies,
in the care of contact lenses. These have included formulations that have been associated with
unique infectious outcomes, controversies about preservatives, corneal staining, and the
impact of a rub step. Further, new materials are posing different challenges relative to their
care. The purpose of this talk is to review and discuss these topics in an interactive format.
LEARNING OBJECTIVES (2 hours CE):
1. To identify the important components and structures of the tear film and corneal and
conjunctival anatomy, and diagnostics used in their assessment,
2. To discuss the interaction between a contact lens, the tear film, the ocular surface,
3. To discuss our current understandings of comfort during contact lens wear, and factors
associated with contact lens intolerance,
4. To discuss the major components of contact lens care systems,
5. To discuss the impact of using multipurpose solutions on the tear film and ocular
surface, and
6. To review strategies for protecting contact lens wearers from adverse events and
discomfort.
I. Anatomical Review
A. Tear film
B. Cornea
Copyright 2011, Dr. Jason J. Nichols
Nichols, JJ. Contact Lens Care.
C. Conjunctiva
D. Diagnostics techniques
II. The Interaction between a hydrogel lens and the tears and ocular surface
A. Lens settling period
B. Overnight wear
C. Biofilms, deposition, and wettability
III. Milestones in contact lens materials and care systems
A. Materials overview and update
1. Major components
2. Contemporary technologies, trends, and clinical understandings
B. Care system overview
1. Oversight and Regulation: Traditional considerations and recent news
2. Four functions
a) Disinfection
b) Cleaning
c) Lubrication (comfort?)
d) Wetting (comfort?)
C. What patients want?
1. Convenience
Copyright 2011, Dr. Jason J. Nichols
Nichols, JJ. Contact Lens Care.
2. Safety
3. Comfort
D. What doctors want?
1. Compliance
a) Hand-washing
b) Regular lens and case replacement
c) Rinse (and rub, when appropriate)
2. Safety: A balance of toxicity and efficacy
3. Efficacy:
a) Disinfection
b) Cleaning
4. Comfort
IV. Strategies for Preventing Adverse Events such as Infection
A. Historical rates with contact lens wear
B. Impact of silicone hydrogels
C. Rates with MPS and other care systems
D. What happened with Fusarium?
E. What happened with Acanthamoeba?
V. Comfort—What is “Contact Lens-Related Dry Eye?”
A. Prevalence: Signs or Symptoms?
Copyright 2011, Dr. Jason J. Nichols
Nichols, JJ. Contact Lens Care.
B. Is it really dry eye? Factors to consider…
1. Definition of dry eye
2. Tear film factors
3. Material factors
4. Deposition/care solution factors
5. Patient factors
VI. Treatment Strategies (Keep Them In Lenses!)
A. The impact of age: Get them in lenses early!
B. Materials and care solutions
C. Replacment schedules
D. Psychology
Copyright 2011, Dr. Jason J. Nichols