Contact Lens Fitting and Work Placement (15 ECTS)

Objective

The student are able to
• Explains the terminology related to contact lenses and their use
• describe the characteristics of different contact lenses including materials (Dk, Dk / t, EOP, oxygen flux, ionic, water content), form factors and manufacturing, and uses
• describe and calculate the optical properties of contact lenses
• compare the differences in the correction wit contact lenses vs. spectacles
• describe the methods and results of the contact lenses fitting, as well as the significance of the results for the successfull use.
• describe the use of care products, content / ingredients
• describe the most important contact lens complications and treatments
• describe the basic features of special lenses (color, therapeutic, myopia control, scleral, miniscleral, toric RGP, orthokeratology, hybrid, contact lenses for children and babies)
SKILL
The student are able to
• take a history for contact lens fitting and evaluate the suitability of contact lenses
• evaluate the anterior part of the eye by microscopy for the use of contact lenses, including lid eversion and fluorescein examination
• evaluate the possibility of dry eye and provide care if necessary
• evaluate the shape of the cornea using keratometry and topography and calculate corneal astigmatism and residual astigmatism.
• use the contact lens devices safely and ergonomically
• insert the lenses (soft, corneal and miniscleral RGP) in one´s eye and remove them
• fit soft contact lenses including toric and multifocal lenses
• fit RGP spherical contact lenses in basic cases
• provide training for the first time user including hygiene considerations and the use of contact lens solutions
• carry out a follow-ups
• measure the basic parameters of the contact lens
• record the relevant information on the patient record clearly and write a prescription
• apply the legislation and recommendations in relation to contact lenses fitting and patient records
• search for information on lenses and studies on the area of contact lenses
CLINICAL EXAM
The students are able to
- use a microscope and various forms of illumination to examine the anterior part of the eye, and interpret and explain the findings.
- insert and remove the soft and the RGP lenses
- perform the lid eversion and fluorescein examination and evaluate corneal integrity

After work placement (5 ECTS), the students are able to make soft contact lens fittings for clients, guide them in the care products of contact lenses and tell about the use of contact lenses. They are able to guide the customer to the safe use of contact lens wearing. The students are able to perform eye examinations and analyze cases in a versatile manner.

Content

Observation and recognition of clinical signs, and techniques and skills including
Lens types and materials:
o Hard lenses
o Haptics
o Lathecut
o Moulded
o Spincast soft lenses
Optics of contact lenses:
o Curves
o Zones
o Widths and tear lens effects
o Sagittal depth
o Centre and edge thickness
o Flex
o Asphericity and toric designs
o Quadrantic specific designs
o Oblique geometrics with reverse curves
Theories and methods of fitting:
o Lens design
o Specifications of orders
o Lens verification and evaluation
o Insertion and removal techniques
o Design of waring schedules
o Fluorescein evalutation and fitting criteria
Patient selection based upon:
o History
o Analysis of primary care data
o Correlations of data
o Facial Physiognomy
o Contraindications
o Management based upon education
o Patient handling and control
The examination of a new prospective contact lens patient including
o History
o Anterior segment examination
o Measurement of anterior segment
Contact lens selection from presently available types and forms of lenses

Care of lenses:
o Handling
o Cleaning
o Preservatives available
o Disinfection methods
o Solutions
Follow-up care
o Adaptation
o Physiologic and post-fitting complications
o Allergic responses
o Lens changes
o Mechanical problems
Bifocal, mutlifocal and astigmatic contact lenses:
o Types
o Basis of selection and adaptation
o Techniques of fitting
Specially designed lenses and fitting procedures for:
o Keratoconus
o Irregular corneas
o Keratoplastic
o After refractive surgeries
o Sports vision
o Diseased and traumatic corneas
o Cosmetic (prosthetic) use
o Iris colour changes
o Amblyopia
o Colour vision deficiencies
Specially designed lenses and fitting procedures for orthokeratology
Fitting procedures for myopia control
Pediatric contact lens fitting
Parameter modification in theory and practice
Wavefront technology and contact lenses
Treatment and management of refractive/oculomotor/sensory integrative conditions using contact lenses
Pediatric contact lens fitting
Signs and symptoms of eye-related general disorders

Location and time

Spring Semester 2022 Department of Optometry

Materials

The tasks and materials prepared by the teacher are covered by copyright law (Tekijänoikeuslaki 404/61), which guarantees the ownership of these materials to the teacher. Tasks and MATERIALS are not permitted to be used for purposes other than for individual studying. Dissemination of these materials is only allowed with the permission given by the teacher.

Lecture notes, articles
Web-source: https://www.jnjvisioncare.co.uk/educational-moments-clinical-topics
Suggested literature:
Elliott (2014) Clinical Procedures in PRIMARY EYE CARE. Ch. 5 Contact Lens Assessment, pages 112-146.
Phillips and Speedwell (2007) Contact lenses (5th Ed.)
Veys, Meyler, Davies (2002) Essential Contact Lens Practice
Efron (2004) Contact Lens Complications
Efron (2010 and 2018) Contact lens practice
Manufacturers’ websites for product information
J&J Essential Contact Lens Practice
Grading scales : Brien Holden, Alcon, Efron, Johnson & Johnson
Alho, N, Salminen E, Vartela S (2014) Would you fit RGPs? A fitting guide. Thesis, Metropolia. https://www.theseus.fi/bitstream/handle/10024/81946/Alho_Salminen_Vartela_Kokeilisitko_kovia.pdf?sequence=2
JnJ Handbook of Contact Lens Management
Fitting GP Lenses Part 1 - Mark Andre 14:50
https://www.youtube.com/watch?v=8LtavVDuf9c
Fitting GP Lenses Part 2 - Mark Andre 12:25 incl. fluorescein patterns
https://www.youtube.com/watch?v=cMWQ6ZZJSMQ
RGP insertion and removal - Moorfields Hospital 4:07
https://www.youtube.com/watch?v=4lHijsotMww
How to put contact lens in a toddler and baby's eyes 6:13 http://www.youtube.com/watch?v=sxHnoJP4t7I

Additional materials:
CL materials: e.g.
Purslow C (2010) Current materials and care regimes– implications for clinical practice. Optometry Today CET 29.1.2010
Efron, Nathan (2010 and 2018) Contact lens practice editions 2 and 3.

Teaching methods

Interactive lectures
Guided practicals and assignments
Guided problem based individual or group assignment (PBL)
Practicals done and assessed (verbal feedback is given during the practicals)
Workplacement

Exam schedules

Written examination 27.4.2022. Retake 1 30.5.2022. Retake 2 22.8.2022

Completion alternatives

3 weeks workplacement

Student workload

Theory 5 ECTS including lectures followed by a 2-hour exam
Practicals 5 ECTS: students examining and fitting fellow students
-
Work placement in Optometric practice and practical/clinical examinations 5 ECTS

Content scheduling

Work placement 3 weeks

Further information

In case a student has a decision on special support arrangements affecting the course the student needs to contact the teacher in charge right after enrollment period.
Part of the teaching may be conducted in English.

Evaluation scale

0-5

Assessment criteria, satisfactory (1)

The student is able to:
- display learning in professional knowledge and core content in the field
- search information from a variety of sources
- work in various duties in a variety of operating environments
- show that he has achieved the targets for core competence
- display learning in the key safety practices in the field
- act according to ethical principles
- to contribute his learning for the benefit of a group or project

Assessment criteria, good (3)

The student is able to:
- use concepts and knowledge in his field systematically
- find information and assess and use information sources with a critical eye
- apply professional information in professional assignments
- apply professional expertise in various work assignments
- act independently and responsibly in professional contexts
- plan operations with safety in mind
- act according to professional ethics
- act purposefully in working groups and projects

Assessment criteria, excellent (5)

The student is able to:
- use concepts and knowledge in his field professionally
- argue the use of his sources - argue a course of action on the basis of research information or findings
- operate in a range of duties and work situations, also in international contexts
- to act in a way that is customeroriented and displays entrepreneurial spirit
- to act responsibly, taking safety issues into consideration
- argue his choices on the basis of professional ethics
- organise and manage the operation of a group and project

Assessment criteria, approved/failed

The student is able to:
- display learning in professional knowledge and core content in the field
- search information from a variety of sources
- work in various duties in a variety of operating environments
- show that he has achieved the targets for core competence
- display learning in the key safety practices in the field
- act according to ethical principles
- to contribute his learning for the benefit of a group or project

Assessment methods and criteria

Written examination 80%, practicals 20%
Practical assessment sheets returned.
Workplace period completed and written tasks done.
Learning assignments approved
Practical competency assessment: represent 20% of the final course mark. In the practical assessments the students demonstrate their ability to perform microscopy, to use fluorescein, evert upper and lower lids for microscopy and handle contact lenses and insert and remove them appropriately (re safety and hygiene).
All practical work sheets must be returned at the end of the course to be approved.
-
Assessment criteria
Written examination: 50% is required to pass.
Practical competency assessment: points are added to the written points.
Practicals: Absences must be covered by attendance during another session. All practical work sheets must be returned at the end of the course and approved by the lecturers Pass / Redo
Work placement: supervisor optometrist to assess and approve the whole period (grade 1-5) and all eye examinations and contact lens fittings, Pass/redo
All work sheets from work placement must be returned at the end of the period and approved by the lecturers Pass / redo.
-
Permitted aids at the examination
Standard: Pencil, eraser, ruler, calculator.

Qualifications

Binocular Vision

Further information

The study programme (30 ects) is planned for one semester (4 months).

Information about tailored course for incoming exchange students:
SX00DS10 Contact Lens Fitting and Work Placement 10 cr (work placement 5 ects is not offered for exchange students)

Further information

The study programme (30 ects) is planned for one semester (4 months).

Information about tailored course for incoming exchange students:
SX00DS10 Contact Lens Fitting and Work Placement 10 cr (work placement 5 ects is not offered for exchange students)