Prosthetic Contact Lenses

Transcription

1 Prosthetic Contact Lenses Marsha M. Malooley, OD, FAAO Please silence all mobile devices and remove items from chairs so others can sit. Unauthorized recording of this session is prohibited.

2 Disclosure Statement: Nothing to disclose

3 LET ME SHARE A STORY.

4 OVERVIEW INDICATIONS/BENEFITS TYPES OF PROSTHETIC CONTACT LENSES FITTING STRATEGIES CARE AND HANDLING CASE EXAMPLES

5 INDICATIONS/BENEFITS

6 WHAT IS THE PURPOSE OF A PROSTHETIC CONTACT LENS? CHANGE EYE COLOR IMPROVE COSMESIS ALTER LIGHT PERCEPTION BLOCK OFF AXIS LIGHT CREATE ARTIFICIAL PUPIL ENHANCE COLOR VISION OR VISUAL FUNCTION IMPROVE LENS HANDLING OCCLUSION THERAPY

7 INDICATIONS/BENEFITS SIGHTED EYES CORNEAL ABNORMALITIES TRAUMA OR POST SURGICAL COMPLICATIONS IRIS ABNORMALITIES PUPIL ABNORMALITIES RED GREEN COLOR DEFICIENCY PHOTOPHOBIA

8 INDICATIONS/BENEFITS NON-SIGHTED EYES GLOBE ABNORMALITIES CORNEAL ABNORMALITIES LENS ABNORMALITIES PHTHISIS BULBI

9 WHERE TO START ASK THE RIGHT QUESTIONS WHAT GOAL IS THE CONTACT LENS ACHIEVING? IS THERE A TIME CONSTRAINT OR TIMELINE? THINGS TO CONSIDER IS A VISUAL CORRECTION NEEDED? LIGHT COLORED VS DARK COLORED IRIS

10 WHERE TO START PATIENT HISTORY GOAL OF PROSTHETIC OR COLORED CONTACT LENS ASSESSMENT OF PATIENT S EMOTIONAL STATUS EXPLAIN OPTIONS, INCLUDING BENEFITS AND LIMITATIONS DISCUSS COST AND DELIVERY TIME

11 TYPES OF PROSTHETIC CONTACTS

12 TYPES OF PROSTHETIC CONTACT LENSES TRANSPARENT TINTING OPAQUE DESIGNS STANDARD/SEMI-TRANSLUCENT CUSTOMIZABLE HAND PAINTED

13 TRANSPARENT TINTING BENEFITS LESS EXPENSIVE GOOD REPRODUCIBILITY SHORTER MANUFACTURING TIME DISADVANTAGES LIMITED LIGHT CONTROL LESS OPTIONS FOR LIGHT COLORED EYES LACKS IRIS DETAIL

14 TRANSPARENT TINTING PUPIL OPTIONS CLEAR TRANSPARENT BLACK DECENTRATION AND SIZE VARIANCE OF COLORATION IN SOME DESIGNS

15 ENHANCE LIGHT EYE COLOR

16 TRANSPARENT TINT DECENTRATION AND SIZE VARIANCE OF COLORATION PUPIL OPTIONS CLEAR TRANSPARENT BLACK

17 CAN TRANSPARENT TINTED LENSES MASK ABNORMALITIES?

18 ADDITIONAL USES COLOR DEFICIENCY SPORTS TINTS POST CONCUSSIVE PHOTOPHOBIA DYSLEXIA LIGHT SENSITIVE CONDITIONS MIGRAINES LIGHT TRIGGERED SEIZURES COMPUTER VISION SYNDROME

19 BIOMED THERAPUTIC TINTS CHROMAGEN X-CHROM LENS CUSTOM TINTS

20 LD GREENSPAN PROSTHETIC CONTACT LENSES IN POST-CONCUSSION PHOTOPHOBIA INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 2015 Sun Tac Reduces overall brightness while preserving 100% normal color

21 OPAQUE DESIGNS

22 OPAQUE DESIGNS BENEFITS HIGHLY REPRODUCIBLE QUICKER MANUFACTURING TIME CAN CONTROL LIGHT DISADVANTAGES LESS CUSTOMIZATION LIMITED CONTROL OVER IRIS DETAIL

23 COMPUTER-GENERATED SEMI-TRANSLUCENT

24 COMPUTER GENERATED SEMI-TRANSLUCENT

25 ENHANCE AND DEFINE NATURAL EYE COLOR

26 COMPUTER GENERATED SEMI-TRANSLUCENT

27 COMPUTER-GENERATED OPAQUE

28 CUSTOM OPAQUE LENS FOUR BASIC PATTERNS PATTERNS ARE STAMPED UP TO 5 PATTERNS Underprint Iris Starburst Limbal V SERIES BEST SUITED FOR PROSTHETICS AND LIGHT COLORED EYES X SERIES NEEDED WHEN COSMETIC FITS OVER DARKER EYE COLORS

29 CUSTOM OPAQUE LENS

30 CUSTOM OPAQUE LENS CANTOR PROSTHETIC NISSEL NATURAL

31 CUSTOM HAND PAINT

32 CUSTOM HAND PAINT BENEFITS TOTALLY CUSTOM COLOR VARIATION AND INCREASE IN DETAIL ABILITY TO ALTER SCLERAL DETAIL DISADVANTAGES LONGER FITTING/MANUFACTURING TIME VARIANCE IN REPRODUCIBILITY MORE EXPENSIVE

33 CUSTOM HAND PAINT FITTING PROCESS TAKE MULTIPLE PICTURES EACH EYE SEPARATELY (FROM 6-12 INCHES) BOTH EYES TOGETHER (FROM 2 FT) TIPS ON TAKING GOOD PICTURES AMBIENT LIGHT (POSSIBLY NATURAL LIGHT) WHITE SHEET IN PICTURE HELPFUL FOR COLOR PERSPECTIVE CLEAR, HIGH QUALITY DIGITAL PICTURE CHECK WITH INDIVIDUAL CONTACT LENS MANUFACTURER

34 CUSTOM HAND PAINT OTHER MEASUREMENTS PUPIL MEASUREMENT HVID KS IF POSSIBLE RX IF INDICATED

35 CUSTOM HAND PAINT

36 CUSTOM HAND PAINT- DECENTERED IRIS DETAIL

37 CUSTOM HAND PAINT With Old Contact Without Contact

38 CUSTOM HAND PAINT- OPAQUE EDGE

39 ADDITIONAL FITTING TIPS GLASSES VISION CORRECTION IMPROVE COSMESIS PROTECTION CONSIDER LIGHT OR GRADIENT TINT

40 ADDITIONAL FITTING TIPS CONSIDER FITTING BOTH EYES CAN BE SAME OR DIFFERENT LENS DIFFICULT TO MATCH LIGHTER EYES POSSIBLY LESS EXPENSIVE OPTION

41 OTHER CONSIDERATIONS PSYCHOSOCIAL COMPONENT EMOTIONAL TRAUMA OCULAR SURFACE

42

43 ADDITIONAL FITTING TIPS SET EXPECTATIONS PATIENT EDUCATION RESPECT THE PROCESS

44 LENS CARE AND HANDLING SPECIFIC TO THE TYPE OF LENS CHECK WITH MANUFACTURER

45 Manufacturer Translucent Tints Computergenerated Hand-paint Lab Provides lens ABB Optical Group yes yes yes yes Adventure in Colors yes yes yes no Advanced Vision no yes yes yes Technologies Alcon yes yes no yes Alden Optical yes yes yes yes Coopervision no yes (d/c 11/1/2019) no yes CR Studios no yes no Custom Colored yes yes yes yes Contacts* Medcorp International no yes yes yes Orion Vision Group yes yes yes yes Specialty Tint yes no no yes** United Contact Lens yes no no yes Vistakon no yes no yes *Must travel to New York **Plano powers only

46 FUTURE CONSIDERATIONS SCLERAL CONTACT LENSES ALTERNATIVE GAS PERMEABLE DESIGNS

47 OUR ROLE AS AN OPTOMETRIST COMPREHENSIVE HISTORY THOROUGH EXAM INCLUDING DILATION CHECKING OCULAR SURFACE AFTER LENS REMOVAL VISION PRESERVATION AND PROTECTION PSYCHOSOCIAL CONCERNS STRESS PROPER CL CARE AND FOLLOW UP

48 THANK YOU! Please remember to complete your session evaluations on the Academy.18 meeting app Tweet about this session using the official meeting hashtag #Academy18