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Semelhante a Paediatric contact lens
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Paediatric contact lens
- 2. INDICATIONS Aphakia Pseudophakia Refractive error Nystagmus Photophobia Amblyopia treatment
- 3. APHAKIA Surgical removal of crystalline lens Congenital cataract Lens subluxation (Marfan’s syndrome) Ectopia lentis Trauma to the eye Could be corrected with spectacles CL- best in unilateral cataract – anisometropia Reduce image blur & unequal image size
- 4. PSEUDOPHAKIA Increment in management of congenital cataract using IOL Alleviate need for glasses or CL later Undercorrect IOL power by 6D – 10D CL use to correct resultan refractive error With 2D overcorrection- decrease as eye undergo emmetropization
- 5. REFRACTIVE ERROR MYOPIA More common in preterm infant Low birth weight & short gestation period - myopia CL improve retinal image size & effective VF, reduce peripheral distortion In high myopia, CL is more satisfactory RGP – control progressive myopia
- 6. REFRACTIVE ERROR HYPEROPIA High hyperopia seen in accommodative esotropia Most common type of strabismus in infant CL eliminate ring scotoma & magnification & prismatic effect CL reduce accommodative effort need for near task
- 7. REFRACTIVE ERROR IRREGULAR ASTIGMATISM Refractive error not correctable with glasses Rigid lens to cover corneal irregularity
- 8. NYSTAGMUS Normally seen in albinism CL can correct refractive error CL use to center optics over the pupil CL reduce prism & spectacles distortion PHOTOPHOBIA use of tinted lens / ring CL Cases of aniridia, iris coloboma
- 9. EXAMINATION SLB Anterior segment In babies - Using flying baby technique Infants – hand held slit lamp Older children – kneeling on chair Keratometry Eyelid & palpebral aperture Pupil & corneal diameter
- 10. EXAMINATION Refraction Normally performed objectively Cycloplegic – recommended Biometry
- 11. LENS SELECTION Key choice in paed Silicone hydrogel Silicone elastomer Rigid lenses
- 12. SOFT LENSES Most frequently used in paediatric fitting High water content (preferably SiHy) Daily wear – reduce risk of infection Advantages Can be custom made Confortable Disadvantages Do not correct significant corneal astig Insertion can be difficult Prone to dehydration Frequent lens loss
- 13. SILICONE RUBBER Commonly used in babies & young children Can prevent lens loss or dry ocular surface Lens fit checked using fluorescein Advantages High O2 permeability Easier to insert Less susceptible to damage Disadvantages Limited parameters Require more chair time Negative pressure effect Surface coating can degenerate
- 14. RIGID LENSES Advantages Large range of materials & parameters Can correct cornela astig Durable Easy to insert & remove Disadvantages Not for continuous wear Risk of abrasion Initial discomfort Ease of dislodgement
- 15. THANK YOU