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Thread: Contact Lens Education

  1. #76
    Paper Shuffler GOS_Queen's Avatar
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    Quote Originally Posted by D-Boy View Post
    Hello all,

    I am new to OptiBoard, and I am wondering if anyone out there can clue me in as to what I should be expected to know for the upcoming NCLE exam on Nov 19. I am working with CLSA's Contact Lens Manual, as well as the CLSA's Test Review (200 sample questions w/answers), but I find that the Test Review questions are far easier than some of the concepts in the CL Manual.

    I spoke to the Test Manager at the NCLE, and she said that if the concept seemed too in-depth for a multiple choice exam where you cannot use a calculator...it is probably not covered in the examination.

    Can anyone give me some pointers based on first-hand knowledge? It would be very much appreciated.
    I just wanted to say Welcome to Optiboard :cheers: Good luck on the test
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    Smells like------Victory." -- Uncle Fester :p


  2. #77
    Master OptiBoarder Snitgirl's Avatar
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    Quote Originally Posted by OPTIDONN View Post
    Hey there are alot of people who are suprised by the amount of RGP questions asked and don't pay the amount of attention that they should to this...your mean

    I'm mean? Lol, its an actual question and I am not being sarcastic one bit...

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    Glad to see that there is life out there....
    Thanks for the tips on studying lens design and modification....
    The other areas of importance seem to be:
    Anatomy/Physiology of the eye
    Rx interpretation>type of lens (K readings vs Refraction)
    Follow-up care and patient instruction...

    Am I on the right track or what? I have been ABO certified since 1997, and am fimally going to tackle the NCLE, and ultimately the AZ state exam. I may be over-preparing (if there is such a thing), but I just want to make sure that I am covering my bases.

  4. #79
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    D-Boy, there is no such thing as over-preparing. Even if it's not on the exam, it'll benefit your career! Best of luck with both those exams!

  5. #80
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    As a general rule, I add 1.5 mm for each of three radius tools to get the desired ski curves. In this example , 7.50 base curve, use 9.00, 10.50 and 12.00. The width of each is also specified, such as .25/9.00 .25/10.50 and .2/12.00. If your diameter was 9.5, yout optical zone is 8.1.
    Bob Taylor
    Last edited by rdcoach5; 01-14-2007 at 12:24 PM.

  6. #81
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    Peripheral curve calculation

    Quote Originally Posted by stephanie View Post
    Ok I have a couple of questions here that came right out of my book. Bear in mind that I do know the answer as I have the answer key. What I don't know is why?

    1. A contact lens has a base curve of 7.50mm. Its posterior peripheral curve would most likely be:
    A) 7.45mm
    B) 42.50 D
    C) 7.35 mm
    D) 30.00 D

    2. Of the curves listed which indicates the flattest base curve?

    A) 7.50mm
    B) 37.50 D
    C) 8.60 mm
    D) 49.00 D
    Like I said I do know what the answer is but I do not understand why.
    Thanks!!
    Steph
    My standard P.C. is 4.5 diop flatter than the Base Curve. A 7.50 B.C would have a 1st intermediate curve of 9.00 2nd int of 10.50 and peripheral curve of 12.00. the width of each is specified, such as .25/9.00 .25/10.50 and .2/12.00. If your diameter was 9.5 , the optic zone is 8.1

  7. #82
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    RDcoach:
    What you have listed is 1.5 mm not 1.5 diopter radius changes. mm is correct but done as written you will have a lot very small optical zones and not much edge lift.

  8. #83
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    You are correct.

  9. #84
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    Optical Training Institute has manuals that a youger co-worker used to pass her exam. That said, it doesn't really teach how to fit contacts-just how to pass the test.
    Bob Taylor

  10. #85
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    Quote Originally Posted by chip anderson View Post
    Jo:

    I am sorry that I did not notice this post directed to me, earlier. Here I have the defense that: "State law require that I have a 'contact lens precription" before I can dispense them or sell them." This man not be the case in all locations. But for me, I am CYA when it comes to giving the board of optometry (although I work almost entirely by M.D. Rx's) a reason to hang me.

    I also explain that when the doctor writes this Rx he is saying that eye eye is healthy enough to wear contact lenses. Many conditons that are not giving trouble can become very severe if aggravated with a contact lens.

    Chip:)
    I also use the "it's the law" defense. Sometimes they don't like that answer, and oh well. We're not putting our license on the line for your convienence. I've definately been fussed out more than once over this, but if Joe down the street doesn't need a prescription, then go see him and let him take the fall.

    I recently was shopping in a beauty supply store and I noticed a young lady go up to the counter and inquire about color contacts. I listened in, thinking I could hand her our card when she was told no. Low and behold, out from behind the counter comes a box of colored contact trials, being sold for $25/ea. I was amazed! My manager was with me, and she elected to inform the powers that be. I can't believe people are buying these things, and putting them in w/o any training, health check, etc.

    In general, though, I do try to stay away from the fire and brimstone. If someone doesn't listen to the "it's the law" argument, I'll go so far as to say, "These laws really are in your best interest since contact lenses not used properly can permanently damage your eyesight."

  11. #86
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    I passed the CLRE (NCLE exam)!

    Whohoo!

    Not only did I pass that exam, but I scored a 90!
    My only observation is that the study material available was totally current and reflected the test content to a "T"!

    Does anyone know of any current ABO Prep material? I just tutored 45 employees to prep for the test, and we had a 60% pass rate. The ones who didn't pass all scored in the 60's, so they were all very close to the goal. Although optical concepts and theories have not changed, it seems that many of my students remarked that the questions on the exam were very different from the sample tests that we took...The sample questions came from a study guide first published in 1989, and was reprinted in 2001...without any updates...

    I feel that the folks I teach would stand an even better chance of passing the ABO if they were exposed to sample questions that better reflect the true content and wording of the test...does anyone have any suggestions? Has anyone looked at the study material offered through Morrison Media? Here is the link: http://www.mo-media.com/noce/

    I look forward to your feedback, and congrats to all others out there who passed their ABO and/or NCLE examinations!

  12. #87
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by D-Boy
    Whohoo!

    Not only did I pass that exam, but I scored a 90!
    My only observation is that the study material available was totally current and reflected the test content to a "T"!
    Congrats :cheers:
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  13. #88
    threadkiller? eromitlab's Avatar
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    wow... I didn't ever notice this thread existed until today. Chip, I am grateful that you are so generous with your knowledge... My doc is starting to move me from the spectacle end of things in the office to contacts/medical stuff, so I am having to learn a lot of new things (most of it on my own). I don't think I would ever be able to find the information you have given from anyone I work with now.

    Thanks so much!! :idea:

  14. #89
    threadkiller? eromitlab's Avatar
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    Chip, I have a question for you.

    My doc likes to have RGP wearers come in on a quarterly basis to have their lenses cleaned in an ultrasonic scrubber. Is this a good or bad thing for the lenses? I can see why it might be good for them, as the scrubbers work great in other applications where stubborn 'dirt' can be removed easily, but, are there any negative effects on the lenses?

    He's also been real hot on having plasma treatments added lately, what are your thoughts on having lenses treated this way?

    Thanks in advance!!

  15. #90
    ATO Member HarryChiling's Avatar
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    I know that in an ultrasonic cleaner sometimes heat is generated that can cause slight warps in the lens, never done it so I don't know if this is an issue. The best cleaning method is to polish the back side in my opinion.
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    My personal observations.

    I have all (Or at least tell them to do so) come in for check-up every six-months. I check for deposits, if found, I buff both front and back lightly or as much as needed. RGP's are bad about collecting a film of deposits that can change the fit sometimes to the extent of locking the lens in place as bad as a keratoconnus lens fit way too snugly. Often you will notice color "changes) blue will look gray and after buffing will return to blue. Check closely after polishing for partial removal of deposits and aberration of optics.

    Make sure patient is using daily cleaner and rubbing (even with no rub regimens) as well as using enzymatic cleaner weekly (they won't be). Avoid the use of "one step" regimens.

    As to sonic cleaner for this, I have known other "experts" who recommend it highly, even went to course in Fla. with mfgs of such things that had bottles and polishes to be use in same. Myself I have not seen any benefits from using sonic cleaners for deposit removal (I have two units but do not use them for this purpose).

    Chip

  17. #92
    threadkiller? eromitlab's Avatar
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    thanks, Harry and Chip for your input. My other question, what solutions do you reccomend using? We only use Boston Simplus right now, mainly because of the lab sending the kits with all of the XO material lenses doc fits. Chip, I see that you have a problem with these as they tend to gum up the cases and leave deposits (I've noticed this since I started reading the thread). I would like to reccomend a possible alternative to doc, but I'm unsure as to what might be better.

  18. #93
    ATO Member HarryChiling's Avatar
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    The simplus is a one step solution, which works well with soft replacement lenses, because you are replaceing them before the lens builds up any significant amount of protein. With RGP's the lens is not disposed, so in my opinion I don't think that the one steps is a option for RGP's. I would recommend going with the boston original or advanced formulas. Tried and true.
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  19. #94
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    When Boston Advance came out (origionally labeled to be for flourosilicon acrilate lenses as opposed to silicont acrilate polymers, which B&L seems to no longer remember haveing said) 80% of our patients prefered Boston origional. 80% of our patients still prefer Boston Origional for both types of lenses. Of those that don't do well with same. Many practioners tell me that me that their patients are too stupid for more than one solution (With my sarcastic nature, this translates to me: "I'm too lazy to teach them anything.")
    For those patients who do not seem to like same we try whatever other solutions are available until we find one that the patient is happy with, always insisting on manual cleaning.

    Chip

  20. #95
    ATO Member HarryChiling's Avatar
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    Chip, what's your opinion on the simplus?
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  21. #96
    ATO Member HarryChiling's Avatar
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    Fitting Keratoconus

    Using a topographic map record the axis and the measure off center that the cone lies, Ksteep; then record the K reading 180 degrees or opposite the same measure from center, Kflat. Now with these two readings you can use the mean K reading as the initial base curve to order and work from there.

    Kmean = (Kflat + Ksteep) / 2

    To determine the minumum diameter, use the measure from center that the cone lies and double it, this gives you a circle that the center of the cone lies on. You can add 3mm to it as a rule of thumb for your edge design and centration.

    If the cone lies in the center of the map use the Kmean as the base curve and for the diameter measure how far from the center of the cone or map to the first Kmean reading, now double this figur and add 3mm to it for your edge design and peripheral curves.

    Of course this is only the intial diagnostic lens. If the lens has too much saggital depth then you should flatten it if it rides too low increase the diameter, if it fits too flat steepen the base curve.

    I just didn't want to let such a great thread die, and someone earlier mentioned about their doctor not letting them fit lenses, so heres some info.
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  22. #97
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    Harry:
    Simplus and all combination solutions from my personal observations of many hundreds of patients. The lenses and the case become gummy in a short period time. Simplus just doesn't provide a good cleaning.
    From what I have been told the only reasons for combination solutions are:
    "My patients are too dumb to use three solutions." Translation: I am too lazy to teach them.
    "My patients won't take the time." Translation: Such patient's don't deserve contacts.
    I actually found that about 80% of our patients actually found on thier own that Boston Advance was not as effective as Boston Origional. Very few find Simplus to be effective, those that do are ususally very rich, spoiled and second generation Ole Miss.

    Chip

  23. #98
    ATO Member HarryChiling's Avatar
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    Thanks for the reply, we have been giving out the simplus, but most of our patients are still using their cleaners from their old solutions. Between the boston orginal and the advanced formula it's 50/50 some patients like the advanced better and some patients prefer to stick to the original and it's usually build up that causes patient to want to stay with the original.

    I have never liked the idea of a one step for a RGP, again it works OK with soft lenses because they are disposable, but even in conventional soft lenses they don't work very well.
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  24. #99
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    Peroxide Solutions add cleaning and disinfecting

    Many years ago I attended a seminar that recommended using a peroxide solution such as Clear Care to remove residual abrasives left from cleaners like Boston. It also removes residual polish from contact lens polishing, as well as hand lotion . Simply rub the lens with the peroxide solution and rinse with water. It should feel squeaky clean. Since it disinfects quickly, I always rub my finger with the peroxide solution before each contact lens class. It cleans those old contact lens cases as well.
    Bob Taylor

  25. #100
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by rdcoach5
    It cleans those old contact lens cases as well.
    I still haven't figured out the obsession with keeping those old dirty cases, I give people new cases and they still don't use them. :hammer:
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