|
Your monthly guide to staff training outside the box
Eyes / Lenses / Fitting Lenses / Free-Form / Frames / Sunwear / Patient Solutions / In-office / Standards
Contact Lenses
SUCCESS TIPS
By Christopher Miller, ABOC, NCLEC
Task #1: Inspire Confidence
Everyone has different communication styles. When training people, some of us tend to get more serious than we usually are. Others are more authoritarian and a few fitters may even "talk down" to people or the opposite, explain every little detail. The author thinks of himself as a "coach" when working with children. The goal is to inspire confidence in them to attain something that usually is a bit harder than it looks at first glance. Get kids to focus on learning the skills necessary without giving them all the details unless they ask specific questions. This way they will easily remember the most important items they need to know to safely wear their new lenses including: washing their hands before handling their lenses, safe insertion and removal of their lenses, cleaning/disinfecting instructions, an initial wearing schedule, the need for backup glasses, normal and abnormal symptoms, and a few of the "must never do" instructions such as never wetting lenses in their mouth or never letting friends wear them.
See Plus »
|
CLIDE
By Linda Conlin, ABOC, NCLEC
With the prevalence of dry eye, an acronym developed but unlike most acronyms, this one—mdash;CLIDE—mdash;describes two issues. The first is for the condition known as Contact Lens-Induced Dry Eye, and the second is for the causes of dry eye: Climate, Drugs, Environment. The acronym becomes a handy tool when we understand the causes of dry eye.
The incidence of dry eye increases in dry, dusty, windy and cold climates. Of the top 20 U.S. cities for dry eye, Las Vegas ranks first and five Texas cities are included in the group as one might expect, but so were Boston and Newark, N.J. Dry eye is so prevalent in Texas that a vision center specializing in dry eye treatment sponsors a Dry Eye Index on the local news in Amarillo, much the way other cities report heat indices or wind chill factors. The Dry Eye Index indicates grades of environmental conditions that result in dry eye symptoms progressing from "clear" to "comfortable" to "uncomfortable" to "miserable."
See Plus »
|
|
|
REVIEW CASE HISTORIES
By Christopher Miller, ABOC, NCLEC
There are several different types of follow-up visits: new fits, toric fits, multifocal fits, rigid gas-permeable fits, specialty lens fits, handling or comfort issues and other patient-initiated visits. Each type of fitting has its procedures and protocols it follows for each type of follow-up visit. I suggest having a different template for each type of fitting and follow-up visit. That way, the process used will be the same for each patient, and nothing important would be overlooked because of time constraints or forgetfulness.
See Plus »
|
WHEN NATURE ISN'T ENOUGH
By Linda Conlin, ABOC, NCLEC
It is normal to see an infant's eyes misaligned at first because of immature focusing and muscle control. If the eyes remain misaligned after 4 months of age, it may be an indication of strabismus. Because the brain is not receiving good messages from the turned eye, amblyopia can result. As many as 5 percent of preschool-aged children have amblyopia, so it is clear that early intervention is important to preserve visual development. Spectacles with an occluder or frosted lens over the normal eye are used to stimulate visual development in the affected eye. When spectacles are impractical for an infant or an active toddler or preschooler, an occluder or high power "fogging" contact lens can be used. Contact lenses offer the benefit of staying in place but require that caregivers be trained to apply, remove and clean the lenses.
See Plus »
|
CONJUNCTIVITIS AND CONTACT LENSES
By Erich Mack, ABOAC, LDO, NCLEC
Adenovirus or viral conjunctivitis (aka viral pink eye) ranks fourth on our fearsome five list. Adenovirus actually consists of a family of virus strains called Adenoviridae. These medium-sized viruses infect a large range of animals and cause a variety of illnesses. For our purposes, we will focus on the notorious pink eye, specifically viral pink eye.
See Plus »
|
CONTACT LENS PROCEDURES FOR YOUNG CHILDREN
By Linda Conlin, ABOC, NCLEC
Contact lenses frequently are a good choice for correcting vision in young children. In correction following surgery for congenital cataracts and in aniseikonia, contact lenses reduce differences in image size between eyes and improve peripheral vision. In amblyopia, an occluder or opaque contact lens is preferable to a patch because it's easier to keep in place. In fact, contact lenses solve the problem for parents who have to keep glasses clean, comfortable and in place for many children who need vision correction.
See Plus »
|
WHEN FITTING THE MATURE CONTACT LENS PATIENT
Christopher Miller, ABOC, NCLEC
They say 50 is the new 40, and 60 is the new 50. Current numbers indicate that a third of the U.S. population was between 40 to 59 years of age at the end of 2010 with 14.5 million turning 40 within the next four years. These aging baby boomers are more active, more style-conscious, have access to knowledge never before possible and have the highest amount of disposable income than any previous generation. Many currently care for one or more parent, and the mix has made health care the number one issue in America. That's because no matter how well we take care of ourselves, with age and all its wisdom also come health issues; some are avoidable, some not. The mature eye has a wider range of conditions to consider that suggests different spectacle and contact lens modalities.
See Plus »
|
DRY EYE CLASSIFICATION
By Linda Conlin, ABOC, NCLEC
The National Eye Institute has identified two classifications of dry eye syndrome based on the type of tear deficiency: aqueous tear deficiency (ATD) and evaporative tear deficiency (ETD). Aqueous tear deficiency, also called keratitis sicca, is an insufficiency in the aqueous or watery layer of tears and is the most common type of dry eye. Causes include lacrimal deficiency, lacrimal gland duct obstruction, reflex block and systemic drugs. Evaporative tear deficiency is an insufficiency of the lipid or oily tear layer which functions to slow tear evaporation. Causes include meibomian oil deficiency, disorders of the lids, low blink rate, drug side effects, vitamin A deficiency, and contact lens wear and ocular surface disease such as occurs from allergies. In addition, patients can suffer from a combination of both ATD and ETD.
See Plus »
|
IDENTIFYING TORIC LENSES
Christopher Miller, ABOC, NCLEC
When a new patient visits and wears RGP contacts, verify if they are toric. Using a lensometer, check the power. Then with a radiuscope check curvature.
Power: Is it spherical or cylindrical (two powers) using a lensometer? Don't worry about axis alignment unless the lens is dotted. This could indicate that the lens is a right lens unless the lens is ballasted, and the dot is at 6 o'clock when it's on the patient.
Curvature: Radiuscope readings would show two distinctly different curves. Make sure that the lines are sharp. If the lens is toric, the values for the two curves will be distinct. If there are two values but blurred and indistinct, the lens is most likely warped and not toric. Confirm the location of the toricity on the lens. Be aware that the radiuscope only reads the back curvature of the lens (base curve), and the lensometer will tell you whether there are two powers.
See Plus »
|
|
