Additional Information
Book Details
Abstract
Effectively manage even the most challenging contact lens complications with help from Contact Lens Complications, 3rd Edition! Award-winning author, clinician, and researcher Professor Nathan Efron presents a thoroughly up-to-date, clinician-friendly guide to identifying, understanding, and managing ocular response to contact lens wear.
- Evaluate and manage patients efficiently with an organization that parallels your clinical decision making, arranging complications logically by tissue pathologies.
- Turn to the lavish illustrations and full-color schematic diagrams for a quick visual understanding of the causes and remedies for contact lens complications.
- Stay up to date with the latest advances and concepts in contact-lens-related ocular pathology, including findings from the Dry Eye Workshop (DEWS), the International Workshop on Meibomian Gland Dysfunction, a new approach to corneal inflammatory events and microbial keratitis, and new instrumentation and techniques for anterior eye examination.
- Consult the most comprehensive and widely-used grading system available , as well as 350 new references that reflect an evidence-based approach, and dozens of superb new illustrations that help you instantly recognize clinical signs.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Contact Lens Complications | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Preface | vii | ||
| Acknowledgements | ix | ||
| Dedication | ix | ||
| Contact lens complications quick-find index | xi | ||
| I Examination and grading | 1 | ||
| 1 Anterior eye examination | 1 | ||
| Burton lamp | 1 | ||
| Slit lamp biomicroscope | 1 | ||
| General construct | 2 | ||
| The slit lamp | 2 | ||
| The biomicroscope | 3 | ||
| Illumination and observation techniques | 4 | ||
| Diffuse illumination | 4 | ||
| Focal illumination – parallelepiped | 5 | ||
| II Eyelids | 39 | ||
| 4 Blinking abnormalities | 39 | ||
| The normal spontaneous blink | 39 | ||
| Mechanism of blinking | 39 | ||
| Types and patterns of blinking | 39 | ||
| Purpose of blinking | 40 | ||
| Alterations to blinking caused by contact lenses | 41 | ||
| Blink rate | 41 | ||
| Blink type | 41 | ||
| Complications of abnormal blinking with contact lenses | 41 | ||
| Lens surface drying and deposition | 41 | ||
| Visual degradation | 42 | ||
| Prolonged lens settling | 42 | ||
| Epithelial desiccation | 42 | ||
| Post-lens tear stagnation | 42 | ||
| Hypoxia and hypercapnia | 43 | ||
| Soft lens staining | 44 | ||
| Rigid lens 3 & 9 o’clock staining | 44 | ||
| Lens design and fitting | 44 | ||
| Management of abnormal blinking with contact lenses | 45 | ||
| Differential diagnosis of blinking abnormalities | 45 | ||
| References | 45 | ||
| 5 Eyelid ptosis | 47 | ||
| Signs | 47 | ||
| Severity | 47 | ||
| Time course of onset | 48 | ||
| Symptoms | 48 | ||
| Prevalence | 48 | ||
| Rigid lenses | 48 | ||
| Soft lenses | 48 | ||
| Pathology | 49 | ||
| Aetiology | 49 | ||
| Aponeurogenic causes of CLIP | 49 | ||
| Forced lid squeezing | 49 | ||
| Lateral eyelid stretching | 49 | ||
| Rigid lens displacement of tarsus | 49 | ||
| Blink-induced lens rubbing | 49 | ||
| Excessive force used in soft lens handling | 49 | ||
| Non-aponeurogenic causes of CLIP | 49 | ||
| Oedema | 49 | ||
| Blepharospasm | 50 | ||
| Papillary conjunctivitis | 50 | ||
| Patient management | 50 | ||
| Prophylaxis | 50 | ||
| Surgical correction | 50 | ||
| Non-surgical management | 51 | ||
| Prognosis | 51 | ||
| Differential diagnosis | 51 | ||
| Aponeurogenic ptosis | 51 | ||
| Non-aponeurogenic ptosis | 52 | ||
| Other contact lens-associated eyelid disorders | 52 | ||
| Increase in palpebral aperture size | 52 | ||
| Embedded lens | 52 | ||
| Ectropion | 52 | ||
| Entropion | 53 | ||
| Lagophthalmos | 53 | ||
| Rigid lens ‘bridging’ | 53 | ||
| Absence of eyelid | 53 | ||
| Lids as a lens positioning tool | 53 | ||
| References | 54 | ||
| 6 Meibomian gland dysfunction | 56 | ||
| Prevalence | 57 | ||
| Signs and symptoms | 57 | ||
| Pathology | 60 | ||
| Aetiology | 60 | ||
| Patient management | 61 | ||
| Warm compresses | 61 | ||
| Heating devices | 61 | ||
| Lid scrubs | 61 | ||
| Mechanical expression | 62 | ||
| Antibiotics | 62 | ||
| Calcineurin inhibitors and cyclosporine | 63 | ||
| Sex hormones | 63 | ||
| Essential fatty acids | 63 | ||
| Artificial tears | 63 | ||
| Topical lipid supplements | 63 | ||
| Intraductal probing | 63 | ||
| Surfactant lens cleaning | 63 | ||
| Prognosis | 64 | ||
| Differential diagnosis | 64 | ||
| Other contact lens-associated meibomian gland disorders | 64 | ||
| References | 65 | ||
| 7 Eyelash disorders | 67 | ||
| External hordeolum (stye) | 67 | ||
| Blepharitis | 67 | ||
| Staphylococcal anterior blepharitis | 68 | ||
| Seborrhoeic anterior blepharitis | 68 | ||
| Implications for contact lens wear | 68 | ||
| Parasite infestation of eyelashes | 69 | ||
| Mites | 69 | ||
| Demodex folliculorum | 69 | ||
| Demodex brevis | 70 | ||
| General characteristics | 70 | ||
| Lice | 71 | ||
| Treatment of mite infestation | 72 | ||
| Treatment of lice infestation | 73 | ||
| Management in contact lens wearers | 73 | ||
| Other contact lens-associated eyelash disorders | 73 | ||
| Insects trapped in eyelashes | 73 | ||
| Shedded eyelash entering the eye | 74 | ||
| Trichiasis | 74 | ||
| Distichiasis | 75 | ||
| References | 75 | ||
| III Tear film | 76 | ||
| 8 Dry eye | 76 | ||
| The normal tear film | 77 | ||
| Structure | 77 | ||
| Function | 77 | ||
| Signs of tear film dysfunction in contact lens related dry eye | 78 | ||
| General observation | 78 | ||
| Tear volume | 78 | ||
| Tear film structure and quality | 79 | ||
| Tear film stability | 81 | ||
| Ocular surface staining | 82 | ||
| Lid-wiper epitheliopathy | 82 | ||
| Lens deposits | 82 | ||
| Post-lens tear film | 83 | ||
| Symptoms | 83 | ||
| Pathology and aetiology | 83 | ||
| Osmolarity | 84 | ||
| Acid–base balance (pH) | 84 | ||
| Composition | 84 | ||
| Temperature | 85 | ||
| Tear film turnover | 86 | ||
| Tear break-up | 86 | ||
| Feedback model | 87 | ||
| Treatment | 87 | ||
| Choice of contact lens | 87 | ||
| Hydrogel lenses | 87 | ||
| Silicone hydrogel lenses | 87 | ||
| Choice of contact lens care solutions | 87 | ||
| Re-wetting drops | 88 | ||
| Soft lens soaking | 88 | ||
| Nutritional supplements | 88 | ||
| Oral omega-6 essential fatty acids | 88 | ||
| Control of evaporation | 89 | ||
| Reduction of tear drainage | 89 | ||
| Tear stimulants | 89 | ||
| Management of associated disease | 90 | ||
| Bandage lenses | 90 | ||
| Reduced wearing time or cessation of lens wear | 90 | ||
| Cessation of smoking and avoidance of passive exposure to cigarette smoke | 90 | ||
| Prognosis | 90 | ||
| Differential diagnosis | 90 | ||
| References | 91 | ||
| 9 Mucin balls | 95 | ||
| Signs | 95 | ||
| Time course | 96 | ||
| Prevalence | 96 | ||
| Associated observations | 97 | ||
| Symptoms | 97 | ||
| Aetiology | 97 | ||
| Pathology | 98 | ||
| Structure and composition of mucin balls | 98 | ||
| Pathogenesis of mucin ball formation | 98 | ||
| Consequential pathology | 99 | ||
| Management | 100 | ||
| Prognosis | 100 | ||
| Differential diagnosis | 100 | ||
| References | 101 | ||
| IV Conjunctiva | 102 | ||
| 10 Conjunctival staining | 102 | ||
| Appropriate staining agents | 102 | ||
| Staining technique | 103 | ||
| Signs and symptoms | 104 | ||
| The normal eye | 104 | ||
| Contact lens wear | 105 | ||
| Prevalence | 105 | ||
| Types of staining | 105 | ||
| Stipple staining | 105 | ||
| Arcuate staining | 106 | ||
| Lid-parallel conjunctival folds (LIPCOF) | 106 | ||
| 3 & 9 o’clock staining | 107 | ||
| Pathology | 107 | ||
| Interpreting fluorescein staining | 107 | ||
| Impression cytology | 107 | ||
| Confocal microscopy | 107 | ||
| Other approaches | 108 | ||
| Aetiology | 108 | ||
| Treatment | 109 | ||
| Prognosis | 110 | ||
| Differential diagnosis | 110 | ||
| References | 110 | ||
| 11 Conjunctival redness | 113 | ||
| Definitions | 113 | ||
| Prevalence | 113 | ||
| Signs and symptoms | 114 | ||
| Pathology | 115 | ||
| Aetiology | 115 | ||
| Metabolic influences | 116 | ||
| Chemical influences | 116 | ||
| Toxic reaction | 116 | ||
| Allergic reaction | 116 | ||
| Neural control | 116 | ||
| Inflammation | 117 | ||
| ’Contact lens acute red eye’ syndrome | 117 | ||
| Mechanical influences | 117 | ||
| Observation and grading | 118 | ||
| Treatment | 118 | ||
| Alteration to the lens | 118 | ||
| Alteration to care systems | 119 | ||
| Improving ocular hygiene | 119 | ||
| Pharmaceutical agents | 119 | ||
| Prognosis | 119 | ||
| Differential diagnosis | 120 | ||
| References | 121 | ||
| 12 Papillary conjunctivitis | 122 | ||
| Prevalence | 122 | ||
| Normal tarsal conjunctiva | 123 | ||
| Signs and symptoms | 123 | ||
| Pathology | 125 | ||
| Aetiology | 125 | ||
| Mechanical trauma | 125 | ||
| Immediate hypersensitivity | 126 | ||
| Delayed hypersensitivity | 126 | ||
| Individual susceptibility | 126 | ||
| Meibomian gland dysfunction | 127 | ||
| Observation and grading | 127 | ||
| Treatment | 128 | ||
| Alteration to the lens | 128 | ||
| Alteration to care systems | 128 | ||
| Improving ocular hygiene | 128 | ||
| Pharmaceutical agents | 129 | ||
| Mast cell stabilizers | 129 | ||
| Corticosteroids | 129 | ||
| Non-steroidal anti-inflammatory agents | 129 | ||
| Antihistamines | 129 | ||
| Vasoconstrictors | 130 | ||
| Combination therapy | 130 | ||
| Prognosis | 130 | ||
| Differential diagnosis | 130 | ||
| References | 131 | ||
| V Limbus | 133 | ||
| 13 Limbal redness | 133 | ||
| Signs and symptoms | 133 | ||
| Anatomical considerations | 133 | ||
| Clinical observations | 134 | ||
| Pathology | 135 | ||
| Aetiology | 136 | ||
| Hypoxia | 136 | ||
| Infection | 136 | ||
| Inflammation | 136 | ||
| Trauma | 137 | ||
| Solution toxicity or hypersensitivity | 137 | ||
| Lens deposits | 137 | ||
| Management | 137 | ||
| Prognosis | 137 | ||
| Differential diagnosis | 138 | ||
| References | 139 | ||
| 14 Vascularized limbal keratitis | 140 | ||
| Signs and symptoms | 140 | ||
| Grade 1 | 140 | ||
| Grade 2 | 140 | ||
| Grade 3 | 141 | ||
| Grade 4 | 141 | ||
| Pathology | 141 | ||
| Aetiology | 141 | ||
| Treatment | 142 | ||
| Grade 1 | 142 | ||
| Grade 2 | 142 | ||
| Grade 3 | 142 | ||
| Grade 4 | 142 | ||
| Prognosis | 142 | ||
| Differential diagnosis | 144 | ||
| References | 145 | ||
| 15 Superior limbic keratoconjunctivitis | 146 | ||
| Prevalence | 146 | ||
| Signs and symptoms | 147 | ||
| Pathology | 148 | ||
| Aetiology | 149 | ||
| Thimerosal hypersensitivity | 149 | ||
| Thimerosal toxicity | 150 | ||
| Mechanical effects | 150 | ||
| Lens deposits | 150 | ||
| Hypoxia beneath upper lid | 151 | ||
| Treatment | 151 | ||
| Suspension of lens wear | 151 | ||
| Elimination of thimerosal | 151 | ||
| Alteration to the lens | 151 | ||
| Pharmaceutical agents | 151 | ||
| Bandage lenses and pressure patching | 152 | ||
| Surgery | 152 | ||
| Prognosis | 152 | ||
| Differential diagnosis | 152 | ||
| References | 153 | ||
| VI Corneal Epithelium | 155 | ||
| 16 Corneal staining | 155 | ||
| Prevalence | 155 | ||
| Non-lens wearers | 155 | ||
| Lens wearers | 155 | ||
| Signs and symptoms | 156 | ||
| Vital stains | 156 | ||
| Fluorescein | 156 | ||
| Sequential fluorescein staining | 156 | ||
| Rose Bengal | 156 | ||
| Lissamine green | 156 | ||
| Slit lamp biomicroscope appearance | 156 | ||
| Punctate staining | 157 | ||
| Diffuse staining | 157 | ||
| Coalescent staining | 157 | ||
| 3 & 9 o’clock staining | 157 | ||
| Dimple-veil ‘staining’ | 157 | ||
| Inferior epithelial arcuate lesion (’smile stain’) | 158 | ||
| Superior epithelial arcuate lesion (SEAL) | 158 | ||
| Epithelial plug | 159 | ||
| Solution-induced corneal staining (SICS) | 159 | ||
| Preservative-associated transient hyperfluorescence (PATH) | 160 | ||
| Other forms of staining | 160 | ||
| Vision | 160 | ||
| Comfort | 160 | ||
| Pathology | 160 | ||
| Aetiology | 161 | ||
| Mechanical | 162 | ||
| Exposure | 162 | ||
| Metabolic | 162 | ||
| Toxic | 162 | ||
| Allergic | 163 | ||
| Infectious | 163 | ||
| Observation and grading | 163 | ||
| Management and treatment | 164 | ||
| Mechanical | 164 | ||
| Exposure | 164 | ||
| Metabolic | 164 | ||
| Toxic | 164 | ||
| Allergic | 164 | ||
| Infectious | 164 | ||
| Prognosis | 164 | ||
| Differential diagnosis | 165 | ||
| References | 165 | ||
| 17 Epithelial microcysts | 167 | ||
| Prevalence | 167 | ||
| Signs and symptoms | 167 | ||
| Slit lamp biomicroscope appearance | 167 | ||
| Optical effects | 168 | ||
| Vision | 169 | ||
| Comfort | 169 | ||
| Time course of onset | 169 | ||
| Pathology | 169 | ||
| Aetiology | 170 | ||
| Management and treatment | 170 | ||
| Prognosis | 171 | ||
| Ceasing hydrogel extended lens wear | 171 | ||
| Microcyst ‘rebound’ | 171 | ||
| Differential diagnosis | 172 | ||
| References | 172 | ||
| 18 Epithelial oedema | 174 | ||
| Signs and symptoms | 174 | ||
| Vacuoles | 174 | ||
| Bullae | 175 | ||
| Vision | 175 | ||
| Pathology | 175 | ||
| Inferences from clinical observations | 175 | ||
| Electron microscopic studies | 176 | ||
| Aetiology | 176 | ||
| Management | 176 | ||
| Prognosis | 177 | ||
| Differential diagnosis | 177 | ||
| References | 177 | ||
| 19 Epithelial wrinkling | 179 | ||
| Prevalence | 179 | ||
| Signs | 179 | ||
| Symptoms | 181 | ||
| Pathology | 181 | ||
| Aetiology | 182 | ||
| Treatment | 182 | ||
| Prognosis | 183 | ||
| Differential diagnosis | 183 | ||
| References | 184 | ||
| VII Corneal Stroma | 185 | ||
| 20 Stromal oedema | 185 | ||
| Definition | 185 | ||
| Central corneal clouding (CCC) | 185 | ||
| Prevalence | 186 | ||
| Signs and symptoms | 186 | ||
| Striae | 186 | ||
| Folds | 186 | ||
| Haze | 187 | ||
| Pathology | 187 | ||
| Striae | 188 | ||
| Folds | 188 | ||
| Haze | 188 | ||
| Aetiology | 189 | ||
| Observation and grading | 189 | ||
| Grade 0 | 189 | ||
| Grade 1 | 189 | ||
| Grade 2 | 189 | ||
| Grade 3 | 190 | ||
| Grade 4 | 190 | ||
| Management and treatment | 190 | ||
| Alleviating rigid lens oedema | 190 | ||
| Material Dk | 190 | ||
| Lens thickness | 190 | ||
| Base curve | 190 | ||
| Edge lift | 190 | ||
| VIII Corneal Endothelium | 272 | ||
| 27 Endothelial bedewing | 272 | ||
| Incidence | 272 | ||
| Signs and symptoms | 272 | ||
| Pathology | 273 | ||
| Aetiology | 274 | ||
| Patient management | 275 | ||
| Prognosis | 275 | ||
| Differential diagnosis | 275 | ||
| References | 276 | ||
| 28 Endothelial blebs | 278 | ||
| Prevalence | 278 | ||
| Signs and symptoms | 278 | ||
| Pathology | 279 | ||
| Electron microscopy | 279 | ||
| Slit lamp biomicroscopy | 280 | ||
| Confocal microscopy | 280 | ||
| Aetiology | 281 | ||
| Observation and grading | 282 | ||
| Management | 282 | ||
| Prognosis | 283 | ||
| Differential diagnosis | 283 | ||
| References | 283 | ||
| 29 Endothelial cell redistribution | 285 | ||
| Normal endothelial cell density | 285 | ||
| Signs and symptoms | 286 | ||
| Pathology | 287 | ||
| Aetiology | 287 | ||
| Observation and grading | 288 | ||
| Management | 288 | ||
| Prognosis | 289 | ||
| Differential diagnosis | 289 | ||
| References | 289 | ||
| 30 Endothelial polymegethism | 291 | ||
| Normal corneal morphology | 291 | ||
| Signs and symptoms | 291 | ||
| Corneal exhaustion syndrome | 292 | ||
| Prevalence | 292 | ||
| Pathology | 293 | ||
| Aetiology | 295 | ||
| Observation and grading | 295 | ||
| Management | 296 | ||
| Prognosis | 296 | ||
| Differential diagnosis | 297 | ||
| References | 297 | ||
| Appendices | 299 | ||
| Appendix A Grading scales for contact lens complications | 301 | ||
| Appendix B Guillon tear film classification system | 307 | ||
| Index | 313 | ||
| A | 313 | ||
| B | 313 | ||
| C | 313 | ||
| D | 314 | ||
| E | 314 | ||
| F | 315 | ||
| G | 315 | ||
| H | 315 | ||
| I | 316 | ||
| K | 316 | ||
| L | 316 | ||
| M | 316 | ||
| N | 317 | ||
| O | 317 | ||
| P | 317 | ||
| R | 317 | ||
| S | 317 | ||
| T | 318 | ||
| U | 318 | ||
| V | 318 | ||
| X | 318 | ||
| Y | 318 |