6 month follow up

[stiff]

what would be an accurate procedure for a 6 month follow up for a s.c.l. wearer

[Dave Nelson]

Monocular snellen check, slit lamp lenses in, slit lamp lenses out, review wear and care procedures. Optional: stain, re-check K readings.

[Shwing]

Fx is optional????

yikes.

[Dave Nelson]

I have yet to see an epithelial disturbance that I can detect with staining, that I cannot without. A proper slit lamp check, with high-oblique and retro-illumination will show me even a tiny epithelial disturbance, without staining, although I instill flourescein when I do see such a disturbance, since staining will give me a better picture of the anomoly, as well as allowing an assessment of the speed and intensity of the staining. Having said that, It may be bad advice for someone starting out, since there are corneal anomolies that may be apparent with staining that they may miss without it. So lets move the staining from the "optional" side and put it in the "do it" side, at least for now. Re-checking K readings is something I do more often than most. I find the quality of the mires as well as the consistancy of the readings to be a good indicater of corneal health and stability. Mire assessment with lenses in-situ also gives a good indication of the fit and stability of scl.