Technician role in fitting lenses

Contact lensA medical device supported by the lids,

cornea, conjunctiva and tear film to correct a patient’s vision.

Technician role in fitting CL’sThe technician gathers all pertinent

information to see whether or not a specific patient is a good candidate for CL’s and which type of CL is best for them.

1.Patient interview 2.Ocular exam3.Material lens selection4.Trail lens examination5.Teaching lens care,lens insertion and removal

Technician role in lens fitting Patient interview1. Patient health and history- ocular and

systemic2. Occupation3. Hobbies4. Previous eye care and/or correction5. What do they hope to achieve6. Motivation7. What can they afford/ insurance8. Age vs. understanding the care and safety

Technician role in lens fittingOcular exam1.VA with and without correction2.Refraction, distance and near (with cycloplegic)3.Keratometry4.Tenometry5.Color vision test6.Visual field, if indicated7.Corneal, pupil, and iris measurement, before

dilation8.Pupil size and reactivity9.Tear and blink function10.Blink rate and lid tension

Technician role in lens fittingLens material selection1.Soft contacts lens a. spherical vs. toric ( sphericocylindrical)

correction b. single vision vs. multifocal c. base curve, diameter, power d. manufacturer2.Gas Permeable a. single vision vs. multifocal b. base curve, diameter, power and lens material

Technician role in lens fitting Trial lens fitting1. Comfort2. Visual acuity3. Over refraction (if VA is not 20/20)4. Verification of fit ( under slit lamp exam)5. Make modifications, if necessary

Technician role in lens fittingEducation 1.Teaching care and handling of lenses2.Teaching insertion3.Teaching removal

Keratometer/ophthalmometerTo assess curvature and power of the corneal

surface. May also be used to assess the integrity of the cornea and tear surface.

Gives the base curve of the corneal meridians.

Technician role in lens fitting

Technician role in lens fittingKeratometry Have patient take off specs. Focus eyepiece. Adjust patient in chin rest. Move keratometer up or down to

match hash marks with patient’s outer canthus.

Move keratometer left to right to align with corneal reflection.

Look into scope and align lower right hand circle + in center.

Adjust focusing knob forward or back until double mires are gone

Adjust horizontal +’s until they are overlapping.

Adjust vertical –’s until they are overlapping

Record. Repeat same procedure for OS.

Technician role in lens fittingRecord each eye separately.Record according to office policy: a. OD 42.00/44.00 x 180 OS 42.50/43.50x

180 b. OD 42.00x 90/44x 180 OS 42.50x

90/43.50x 180Record the condition of the mires, i.e.…clear

and regular or distorted and blurry.

Technician role in lens fittingWith vs. againstFlattest Keratometry

reading 39.00Steepest Keratometry

reading 47.00Lower is flatHigher is steep

Technician role in lens fittingTypes of astigmatismWith-the-rule In with the rule corneal astigmatism the horizontal

meridian is the flattest and the vertical meridian is the steepest.

42.00x 180/44.00x 90Against-the-rule in against the rule astigmatism the horizontal

meridian is the steepest and the vertical meridian is the flattest.

44.00x 180/ 42.00x 90

See you next week for anatomy lecture.