Ocular Changes During Sleep
Five major 'environment' changes when the eyes are closed.
There is no lid actions (blinking) to aid tear exchange and to eliminate debris.
There is a reduction in the oxygen supply to the cornea.
The tears become more acidic.
There is an increase in corneal temperature which can lead to increased corneal metabolic activity.
There is change in tear osmolarity due to no tear evaporation.
All these changes can affect contact lens wear.
Compliance
1.To enjoy symptom-free contact lenses, compliance is very important. Proper usage of the lens and lens care is of utmost importance. If significant bacterial contamination is introduced into the eye, an eye infection may result, therefore, strict hygiene in handling contact lenses is absolutely essential. Reports of any serious complications associated with contact lenses are rare, but usually the cause of these rare cases has been traced to some serious neglect by the patient of the instructions on hygiene, wearing schedule or maintenance procedures.
2.Optometrists/contact lens practitioners who practice Ortho-k should also ensure that they provide professional and ethical services to their patients, are properly equipped to provide Ortho-k service, and are kept up to date with their skills. It is important to communicate effectively with the patient, gain the patient's confidence, establish good rapport, and to avoid overstating the advantages and disadvantages of Ortho-k. Careful assessment and monitoring of the patient's ocular integrity is also essential to minimise complications.
Important points for patients to note
1.EACH TIME, before handling the contact lenses, wash your hands thoroughly ensuring that the sides of the fingers and the palms are cleaned. Ensure that your fingers are free of lint, cosmetics, hand lotions, hair oils, nicotine etc.
2.Contact lenses are made of plastic materials and if handled carelessly they may be scratched, distorted, chipped or split. These imperfections may be too small for naked eye observations. They can be located by your optometrist/contact lens practitioner with proper equipment during follow-up consultations. Small defects on the lens may not cause any symptoms but may allow accumulation of debris that can harbour microorganisms.
3.Do not slide or scrape a lens across a tabletop and be sure that your fingernails do not scratch the surface or dent the edge of the lens.
4.If you suspect that your lens might be damaged, have it checked by your optometrist/contact lens practitioner.
Use of contact lens solutions:
1.The tip of bottles should not come into contact with the lens, fingers or any other surface to minimise the risk of contamination.
2.The soaking solution should be changed every day, the lens container should be cleaned before use.
3.Do not change your solutions without consulting your optometrist/contact lens practitioner first, some solutions may not be compatible with the type of lenses you are using or may contain different preservatives which may cause allergy response
4.The time required for adaptation and the reactions to Ortho-k lens wear vary between individuals. It is important to be able to distinguish between "normal" adaptation problems and signs or symptoms that require advice from your optometrist/contact lens practitioner. 5.All contact lens accessories (including suckers and lens case) should be cleaned properly before use, disinfected appropriately and replaced regularly.
**Parents of children who are unable to handle their contact lenses hygienically should be prepared to do these for their children, or if not, SHOULD NOT allow their children to undergo Ortho-k treatment.
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