1 / 91

Vinita Allee Henry, OD, FAAO

Vinita Allee Henry, OD, FAAO. Disinfecting Soft Lenses. Thermal Disinfection (not used) Chemical Disinfection Oxidative Disinfection. Advantages Convenient Simple Compliance. Disadvantages Preservatives Disinfection time Cost Little effect on AIDS/Acanthamoeba. Chemical Disinfection.

inge
Download Presentation

Vinita Allee Henry, OD, FAAO

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Vinita Allee Henry, OD, FAAO

  2. Disinfecting Soft Lenses • Thermal Disinfection (not used) • Chemical Disinfection • Oxidative Disinfection

  3. Advantages Convenient Simple Compliance Disadvantages Preservatives Disinfection time Cost Little effect on AIDS/Acanthamoeba Chemical Disinfection

  4. Soft Contact Lens Solutions

  5. Preservatives used to Disinfect • Must not be toxic to the ocular tissue • Must demonstrate ability to kill bacteria

  6. Polyquad Aldox Isopropanol H2O2 Dymed (PAPB) Polyhexamethylene Biguanide Polyhexanide Preservatives/Disinfectants

  7. Redness Itching Burning Dryness Lens Intolerance Decreased WT Sensitivity Symptoms

  8. Recalls • ReNu Moisture Loc Alexidine preservative • Complete Moisture Plus

  9. Fusarium keratitis • Started in Asia • 17 states in US, not MO • 30 cases in US, 26 admitted ReNu or B&L generic products • Recalled ReNu MoistureLoc off shelves • Tx: Natacyn (natamycin 5%)

  10. Fusarium keratitis • The classic description of fungal keratitis is a grayish-white corneal infiltrate with a rough, dry texture and feathery borders. Satellite lesions are common and hypopyon and endothelial plaque may also be observed. Intact and slightly elevated epithelium overlying a deep stromal infiltrate may also be seen.

  11. Signs and Symptoms • Red and irritated eyes lasting for an unusually long period of time after lens removal • Pain in and around the eyes especially if it progressively worsens • Increased sensitivity to light • Rapid onset of blurred or fuzzy vision • Excessive tearing or discharge

  12. Top 6 Recommendations for Clean and Safe Contact Lenses • Always wash your hands before handling contact lenses. • Carefully and regularly clean contact lenses, as directed by your optometrist. If recommended, rub the contact lenses with fingers and rinse thoroughly before soaking lenses overnight in sufficient multi-purpose solution to completely cover the lens. • Store lenses in the proper lens storage case and replace the case every three months. Clean the case after each use, and keep it open and dry between cleanings. • Use only products recommended by your optometrist to clean and disinfect your lenses. Saline solution and rewetting drops are not designed to disinfect lenses. • Only fresh solution should be used to clean and store contact lenses. Never re-use old solution. Contact lens solution must be changed according to the manufacturer's recommendations, even if the lenses are not used daily. • Always replace old contacts when you get a new contact lens prescription. When wearing or cleaning contacts: • Never put contact lenses in the mouth or moisten them with saliva, which is full of bacteria and a potential source of infection. • Don't use tap water or homemade saline solutions. Improper use of solutions has been linked to a potentially blinding condition among soft lens wearers. • Never use contacts that have not been prescribed by an eye doctor. Contact lens wear is not an option for everyone; consult with an optometrist to see if contact lenses are an appropriate choice for vision correction.

  13. Thimerosal & Chlorhexidine

  14. Purging

  15. Patient Care Nuggets • Cleaning: Rubbing vs. Rinsing • Long-term Storage • Overnight Storage • Lubricating the Lenses • Dry Eyes

  16. What about Generic or Private Label Solutions?

  17. Advantages: Rapid Effective No preservatives Cleans & bleaches Disadvantages: Costly More complicated Punctate keratitis Oxidative Disinfection

  18. Oxidative Disinfection • H2O2 is changed to H2O and Oxygen by a catalyst • Can use dilution • What about brown bottle peroxide

  19. Patient Care Nuggets • Cleaning with oxidative disinfection • Pink indicator • Storage

  20. Alternative Disinfection • Purilens – UV Radiation • Lensoclean – Ultrasonic

  21. Silicone Hydrogel Lens Care

  22. Lens Care • Aquify (Ciba Vision) • Must rub the lenses with MPS • Presoak lenses to improve wettability

  23. Lens Care • Andrasko Staining Grid (staining assessed after 2 hrs. of wear & overnight soaking) • IER Matrix Study (staining evaluated 3 times over 3 mth. DW period)

  24. Comparison of IER Matrix study with Andrasko Staining Grid(Taken from Mack CJ. Contact Lenses 2007, CLS 23(1):32.)

  25. Lens Care • Ciba Vision study compared ClearCare to OF Replenish, OF Express, Complete MoisturePlus, ReNu MultiPlus with O2 Optix, PureVision, AV Advance and Oasys- 187 subjects • Conclusion: ClearCare was superior for comfort at insertion, end-of-day and preventing irritation at the end of the day.

  26. Source of Deposits • Moist lens • Surface quality of the lens • Poor blinking/tears • Poor cleaning • Hands • Environment

  27. Deposits cause: • Decreased preservative action • Decrease oxygen • Alters parameters/increased movement • Decrease wetting • Decreased WT • Red eyes • Discoloration

  28. Protein- White/opaque Lipids- greasy Jelly bumps – white elevated bumps Most Common Deposits

  29. Other Deposits: • Pigment deposits • Microorganism growth • Rust spots

  30. Surfactant Cleaners • Used Daily • Remove lipids • Use upon lens removal • Rub the lens in a back & forth manner • Rubbing is better than rinsing

  31. Soft Lens Daily Cleaners for those Deposit-Prone Patients • Miraflow • Opti-Free Daily Cleaner

  32. 99% of Acanthamoeba can be removed by rubbing and rinsing prior to disinfection.

  33. Enzymatic Cleaners • Use for traditional replacement lenses • Use for deposit-prone patients • Remove protein • Once a week, or daily enzymatic cleaners • Combination solutions- Disinfect and remove proteins

  34. Enzymatic Cleaners • Ultrazyme • Unizyme • Supra-Clens (also OF RepleniSH rewetting drops)

  35. When to use Salines?

  36. Non-preserved Salines(Exaeris)

  37. VialsSalt Tablets

  38. Lubricants • Blink-N-Clean (AMO) • Clerz Plus, OF Replenish Drops (Alcon) • Aquify (Ciba) • Blink Contacts(AMO) • Refresh Contacts (Allergan) • Theratears (Adv. Vision Research)

  39. Lens Lubricants Use: • EW • Dry eyes • FB • Do not substitute GP ones or other products

  40. Patient Education • Hygiene • Cosmetics • Facial Products • Other Nuggets

  41. Hand washing Tap water Good magnification for those > 40 Foreign body particles Insertion & Removal Holding those lids Always insert the same lens first Avoid rubbing lens in circular motion General Tips for Handling Soft Lenses

  42. Patient Hygiene • Hand Washing • Wash thoroughly prior to handling the lenses • Hand Soaps • Use antibacterial soaps without lotions • Case Cleanliness • Replace the case every 3 months • Dump solution & allow to air dry

More Related