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contact lens contact lens

• A contact lens is a corrective, cosmetic, or • People choose to wear contact lenses for
therapeutic lens usually placed on the cornea of the various reasons.
eye.
– Many consider their appearance to be more attractive
Contact lens with contact lenses than with glasses.
• It has been estimated that 125 million people use – Contact lenses are less affected by wet weather, do
contact lenses worldwide (2%), including 28 to 38 not steam up, and provide a wider field of vision.
million in the United States and 13 million in Japan. – They are more suitable for a number of sporting
activities.
– Additionally, ophthalmological conditions such
as keratoconus and aniseikonia may not be
accurately corrected with glasses.

Types of contact lenses Types of contact lenses By function- Corrective contact lenses
• By function • By wear time • Correctable with contact lenses include near (or
– Corrective contact lenses – daily wear short) sightedness (myopia), far (or long)
– Cosmetic contact lenses – extended wear (EW) sightedness (hypermetropia), astigmatism and
– Therapeutic contact lenses – continuous wear (CW) presbyopia.
• By constructional material • By design • There has been renewed interest in
– Glsss orthokeratology, the correction of myopia by
– spherical contact lens
– P-MMA deliberate overnight flattening of the cornea,
– RGP – toric lens
leaving the eye without contact lens or
– Hydrogel – Bifocal
eyeglasses correction during the day.
– Silicone
– silicone hydrogels

orthokeratology By function- Corrective contact lenses By function- Cosmetic contact lenses


• For those with certain color deficiencies, a red- • A cosmetic contact lens is designed to change
tinted "X-Chrom" contact lens may be used. the appearance of the eye. These lenses may
Although the lens does not restore normal color also correct the vision, but some blurring or
vision, it allows some colorblind individuals to obstruction of vision may occur as a result of the
distinguish colors better. color or design .

ChromaGenTM haploscopic filters Opaque prosthetic contact lenses helped restore


are a unique range of specially this patient's confidence in her self image afte
chromized lenses that are r her right eye was scarred by trauma.
worn as glasses or contact lenses.
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By function- Therapeutic contact lenses

• Soft lenses are often used in the treatment and


management of non-refractive disorders of the eye.
Alibaba Group • A bandage contact lens protects an injured or diseased
Congenital Deformity of Iris - Coloboma, Aniridia, Key Hole Pupil cornea from the constant rubbing of blinking eyelids
Traumatic Eye Injury From Sports etc. thereby allowing it to heal.
Traumatic Eye Injury From Industrial Accidents
Repair of Diseased Eye • They are used in the treatment of conditions including ,
Aniridia dry eyes, corneal ulcers and erosion, keratitis, corneal
edema, descemetocele, corneal ectasis, , anterior
http://www.lensdesign.ca/cosmetic_repair.htm corneal dystrophy, and neurotrophic keratoconjunctivitis.

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By constructional material By constructional material By constructional material


• Visual correction • Stability 硬式鏡片
– Transparent – Chemical stability • The first contact lenses were made of glass,
– Clear which caused eye irritation, and were not
– Proper refractive index – Renitency
– Gas permeability wearable for extended periods of time.
– Homogeneity
– Scratch resistance – Comfort • William Feinbloom introduced lenses made from
• Safety polymethyl methacrylate (PMMA or
• Practicality Perspex/Plexiglas), contacts became much
– Non-toxic
– Easy to handle more convenient.
– Incertness
– Bacterio-static – Not expensive – PMMA lenses have their own side effects: no oxygen
– Compatibility – Consumable is transmitted through the lens to the cornea, which
can cause a number of adverse clinical events.

P-MMA By constructional material By constructional material


• 波長340-1100nm,有92%透光性 • 含矽聚合物 • RGP-improved rigid materials—which were also
– 高透氧硬片材質 oxygen-permeable—were developed. Collectively,
• Refractive index: 1.49,比重 1.18-1.20
these polymers are referred to as or 'RGP'
• 物性良好且穩定,有好的濕潤度,表面不易有 – 旦矽含量太大,則材質過軟 ,且會拒水性強
materials or lenses.
沉澱物 – 故會加一些其他材質增加表面溼度跟硬度 – One advantage of hard lenses is that, due to their non-
• 缺點:透氧率低 • 含氟含矽 porous nature, they do not absorb chemicals or fumes.
– The absorption of such compounds by other types of
– 優點:不易聚集附著物
contacts can be a problem for those who are routinely
– 缺點:製作過程中,車削(lathing)和磨光(polish)不 exposed to painting or other chemical processes.
好掌握

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By constructional material By constructional material By wear time
軟式鏡片
The principal breakthrough in soft lenses made by • In 1999, 'silicone hydrogels' became available. • A daily wear contact lens is designed to be removed
Otto Wichterle led to the launch of the first soft Silicone hydrogels have both the extremely high prior to sleeping.
(hydrogel) lenses. oxygen permeability of silicone and the comfort • An extended wear (EW) contact lens is designed for
and clinical performance of the conventional continuous overnight wear, typically for 6 or more
• P-HEMA
hydrogels. consecutive nights.
– 水化後含水量38.8%,需添加其他材質增加含水量
– makes the lens surface highly hydrophobic and less • Newer materials, such as silicone hydrogels, allow for
– MA:離子性化合物,導致蛋白質附著 "wettable“, results in discomfort and dryness during even longer wear periods of up to 30 consecutive nights;
– NVP:非離子性化合物,導致金屬離子附著 lens wear . these longer-wear lenses are often referred to as
– 水膠透氧性,完全由含水量決定 – hydrogels are added (hence the name "silicone continuous wear (CW).
– 高含水量透氧性高,但容易存污垢,且會有更多附著物於 hydrogels") to make the lenses more hydrophilic
鏡片上
– 低含水量透氧性低,但材質堅韌,鏡片較不易變色且配戴
時水分消失較緩慢,適合偶爾配戴者

conjunctivitis
Corneal neovascularization

By wear time By design


• Extended lens wearers may have an increased risk for • A spherical contact lens is one in which both
corneal infections and corneal ulcers, primarily due to the inner and outer optical surfaces are portions
poor care and cleaning of the lenses, tear film instability,
and bacterial stagnation.
of a sphere .
• Corneal neovascularization has historically also been a • A toric lens is one in which either or both of the
common complication of extended lens wear, though this www.eyetec.net/group7/M36S1.htm www.nlm.nih.gov/.../ency/imagepages/19322.htm
optical surfaces have the effect of a cylindrical
does not appear to be a problem with silicone hydrogel giant papillary conjunctivitis (GPC) lens, usually in combination with the effect of a
extended wear. spherical lens.
• The most common complication of extended lens use is
conjunctivitis, usually allergic or giant papillary
conjunctivitis (GPC), sometimes associated with a poorly
fitting contact lens.

www.clspectrum.com/article.aspx?article=12781

By design-presbyopia or accommodative By design-presbyopia or accommodative


By design-toric lens insufficiency insufficiency
• They correct for both spherical and cylindrical aberration.
• They may have a specific 'top' and 'bottom', as they are • concentric bifocal lens has the near correction in a • A translating lens mimics bifocal glasses. The lens
not symmetrical around their centre and must not be small circle at the center of the lens, and the distance is divided, with the distance correction at the top
rotated. Lenses must be designed to maintain their correction in the outer lens surrounding it. and the near correction at the bottom.
orientation regardless of eye movement.
• Often lenses are thicker at the bottom and this thicker
zone is pushed down by the upper eyelid during blinking
to allow the lens to rotate into the correct position (with
this thicker zone at the 6 o'clock position on the eye).
Toric lenses are usually marked with tiny striations to
assist their fitting.
• They are usually more expensive to produce than non-
toric lenses; therefore they are usually meant for
extended wear. The first disposable toric lenses were
introduced in 2000 by Vistakon.

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By design-presbyopia or accommodative
insufficiency
Others Lens discoloration
• An aspheric lens places both the near and far • Lens discoloration • 鏡片材質老化(Ageing):與不同材質和特性有關,例
correction near the center of the lens. 如軟式與金屬離子結合.
• Deposits
• 外來色素的沾染:例如手上沾有紅色或藍色印泥等.
• Lens cleaning solution
• 藥物及藥水:例如通鼻劑中副腎上腺素,會使鏡片帶
• Enzyme cleaners 棕色.
• Preservatives • 不當加熱:大部分隱形眼鏡藥水使用時都不宜加熱,
• Sterilization and disinfection 例如鏡片與酵素片液加熱,會使鏡片變深咖啡色,且
• Some people with presbyopia may need a technique 會變形.
called monovision. It uses the dominant eye for
• Comfort drops and wetting solution
distance vision, and the other eye for near vision.

Deposits Deposits
• 有機物:主要有蛋白質(protein).脂質(lipids).黏液(mucus).
多醣類(Polysaccharides)
– Protein:主要從淚液中溶菌酶來,必須用酵素溶液清洗.
– Lipids:極普遍會出現附著物,尤其是軟片,比蛋白質難去除,必須用表
面活化劑清洗,鏡片若有脂質附著,蛋白質和其他物質容易附於其上,
型成膠狀物質.
– Microorganism:主要有黴菌類和酵母菌類
• 無機物:主要像鐵、鈣、汞等等
– 鐵:通常以小紅點出現,可能戴或清洗時沾染,加上生理時鹽水促氧
化而成.
– 鈣:通常來自於水晶體去除患者,主要來自大氣中塵埃,或自來水.
– 汞、鎂、矽等:大多來自灰塵,汞附著物呈現輝色或黑色.
– 化妝品:眼線、眼影、睫毛膏等等,含有多種合成份,都有可能會附
著於鏡片上.

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