Knowledge Base
2. Linking EyeSpace to your topographer

3. Dispensing Bespoke Alignment Fit lenses

9. Bespoke Alignment Fit practitioner and patient resourcesCharl Laas

Lens Delivery

  • Eyespace Bespoke lenses should be inspected and cleaned well before dispensing.
  • Verify the engraving against the EyeSpace Cloud Services website.
  • Place one drop of a preservative-free solution with NaFl in the back of the lens.
  • With the patient in a face-down position, insert the lens directly onto the cornea.
  • Allow the lens to settle and assess the lens fit.

Fit Assessment

  • Assess the lens centration and movement.
  • Hold the eyelids and manipulate the lens to a central position for best assessment of the lens alignment, observing the NaFl pattern with a blue light and Wratten yellow filter.
  • If possible, it is good practice to photograph the NaFl pattern in a central position for your record keeping and potential troubleshooting.
  • Note the position and stability of the lens markings for Bespoke toric designs.
  • Perform a sphero-cylindrical refraction over the lens (ROL) on the eye.

Fit Review

  • Review the lens fit at regular intervals: Lens delivery, two weeks, one month and six months.
  • Slit lamp assessment of the ocular surface using NaFl to check for corneal staining or opacity.
  • Schedule annual reviews after completion of the fit.
  • At annual reviews assess lenses for chips, scratches and deposits.
  • Recommend lens replacement is every two years.
  • Communicate to the patient the warranty period for lens adjustments.

Insertion Tips

  • A drop of preservative-free lubricant in the back of the lens on insertion can improve comfort and reduce dryness with lens wear.
  • Insert the lens with the patient face down to avoid air bubbles.
  • An air bubble under the lens will affect the vision and make lens wear uncomfortable. If a bubble is present, remove and reinsert.
  • Aim to insert the lens directly over the pupil.
  • For new wearers, it takes between 10 and 15 days to adapt to RGP contact lenses.
  • Plasma treatment and HydraPEG coating can be applied to improve wettability, comfort and dryness symptoms
  • The patient’s eyes must look good, feel good and see good. When in doubt discontinue lens wear.
  • Contact your distributor if you have any concerns or queries.

Lens accessories

  • Cleaning solutions: Hydrogen peroxides solutions, such as AOSept/Clear Care with HydraGlyde, Oxysept or Easy Sept.
  • Lubricant: Non-preserved lubricant such as HYLO-FORTE, Optive Fusion or Xailin HA eye drops.
  • Intensive cleaning solutions: Menicare Progent, Boston daily or Lobob daily cleaner
  • Removal Tools: DMV Classic or DMV Ultra contact lens remover.

References

  1. Carracedo G1, Martin-Gil A, Peixoto-de-Matos SC, Abejón-Gil P, Macedo-de-Araújo R, González-Méijome JM. Symptoms and Signs in Rigid Gas Permeable Lens Wearers During Adaptation Period. Eye Contact Lens. 2016 Mar;42(2):108-14.