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 |