Bausch-lomb SofLens 59 Contact Lenses Manuel d'utilisateur télécharger pdf

and individual tear composition may cause slight

changes in fitting characteristics.

c. Allow any increase in tear flow to subside before

evaluat

ing the lens. The time required will vary with the

individual.

3. Initial Lens Evaluation

a. To determine proper lens parameters observe the lens

relationship to the eye using a slit lamp.

• Movement: The lens should provide discernible

movement with:

– Primary gaze blink

– Upgaze blink

– Upgaze lag

•

Centration. The lens should provide full corneal coverage.

b. Lens evaluation allows the contact lens fitter to evalu-

ate the lens/cornea relationship in the same manner

as would be done with any soft lens.

4. Criteria of a Well-Fitted Lens

If the initial lens selection fully covers the cornea, provides

discernible movement after a blink, is comfortable and

provides satisfactory visual performance, it is a well fitted

lens and can be dispensed.

5. Characteristics of a Tight (Steep) Lens

A lens which is much too steep may subjectively and

objectively cause distortion which will vary after a blink.

However, if a lens is only marginally steep, the initial sub-

jective and objective vision and comfort findings may be

quite good. A marginally steep lens may be differentiated

from a properly fitted lens by having the patient gaze

upward. A properly fitted lens will tend to slide downward

approximately 0.5mm while a steep lens will remain

relatively stable in relationship to the cornea, particularly

with the blink.

6. Characteristics of a Loose (Flat) Lens

If the lens is too flat, it will:

– Decenter, especially on post-blink.

– Have a tendency to edge lift inferiorly and sit on the lower

lid, rather than positioning between the sclera and palpe-

bral conjunctiva.

– Have a tendency to be uncomfortable and irritating with

fluctuating vision.

– Have a tendency to drop or lag greater than 2.0mm on

upgaze post-blink.

7. Follow-up Care

a. Follow-up examinations are necessary to ensure contin-

ued successful contact lens wear. From the day of dis-

pensing, the following schedule is a suggested guideline

for follow up.

• 3 or 4 days post-dispensing

• 10 days

• 1 month

• 3 months

• every six months thereafter

At the initial follow-up evaluations the eye care profes-

sional should again reassure the patient that any of the

previously described adaptive symptoms are normal, and

that the adaptation period should be relatively brief.

b. Prior to a follow-up examination, the contact lenses

should be worn for at least 4 continuous hours and the

patient should be asked to identify any problems which

might be occurring related to contact lens wear.

c. With lenses in place on the eyes, evaluate fitting perform-

ance to assure that CRITERIA OF A WELL FITTED LENS

continue to be satisfied. Examine the lenses closely for

surface deposition and/or damage.

d. After the lens removal, instill sodium fluorescein [unless

contraindicated] into the eyes and conduct a thorough

biomicroscopy examination.

1. The presence of vertical corneal striae in the posterior

central cornea and/or corneal neovascularization may

be indicative of excessive corneal edema.

2. The presence of corneal staining and/or limbal-

conjunctival hyperemia can be indicative of an unclean

lens, a reaction to solution preservatives, excessive

lens wear, and/or a poorly fitting lens.

3. Papillary conjunctival changes may be indicative of an

unclean and/or damaged lens.

If any of the above observations are judged abnormal, vari-

ous professional judgments are necessary to alleviate the

problem and restore the eye to optimal conditions. If the

CRITERIA OF A WELL FITTED LENS are not satisfied during

any follow-up examination, the patient should be re-fitted

with a more appropriate lens.

PROFESSIONAL FITTING SETS

Lenses must be discarded after a single use and must not

be used from patient to patient.

WEARING SCHEDULE:

The wearing and replacement schedules should be deter-

mined by the eye care professional. The BAUSCH & LOMB

SofLens

59 (hilafilcon B) Visibility Tinted Contact Lens is

recommended by BAUSCH & LOMB for 2 week replacement.

Regular checkups, as determined by the eye care professional,

are extremely important.

Daily Wear:

There may be a tendency for the daily wear patient to over

wear the lenses initially. Therefore, the importance of adher-

ing to a proper, initial daily wearing schedule should be

stressed to these patients. The wearing schedule should be

determined by the eye care professional. The wearing sched-

ule chosen by the eye care professional should be provided

to the patient.

MONOVISION FITTING GUIDELINES:

1. Patient Selection

A. Monovision Needs Assessment

For a good prognosis the patient should have adequately

corrected distance and near visual acuity in each eye. The

amblyopic patient or the patient with significant astigmatism

(greater than one [1] diopter) in one eye may not be a good

candidate for monovision with the BAUSCH & LOMB

SofLens

59 (hilafilcon B) Visibility Tinted Contact Lenses

Contact Lens.

Occupational and environmental visual demands should be

considered. If the patient requires critical vision (visual acuity

and stereopsis) it should be determined by trial whether this

patient can function adequately with monovision.

Monovision contact lens wear may not be optimal for such

activities as:

(1)visually demanding situations such as operating poten-

tially dangerous machinery or performing other potentially

hazardous activities; and

(2)driving automobiles (e.g., driving at night). Patients who

cannot pass their state drivers license requirements with

monovision correction should be advised to not drive

with this correction, OR may require that additional over-

correction be prescribed.

B. Patient Education

All patients do not function equally well with monovision

correction. Patients may not perform as well for certain

tasks with this correction as they have with bifocal reading

glasses. Each patient should understand that monovision, as

well as other presbyopic contact lenses, or other alternative,

can create a vision compromise that may reduce visual acuity

and depth perception for distance and near tasks. During the

fitting

process it is necessary for the patient to realize the dis-

advantages

as well as the advantages of clear near vision in

straight ahead and upward gaze that monovision contact

lenses provide.

2. Eye Selection

Generally, the non-dominant eye is corrected for near vision.

The following test for eye dominance can be used.

A. Ocular Preference Determination Methods

Method 1 - Determine which eye is the "sighting dominant

eye." Have the patient point to an object at the far end of the

room. Cover one eye. If the patient is still pointing directly at

the object, the eye being used is the dominant (sighting) eye.

Method 2 - Determine which eye will accept the added

power with the least reduction in vision. Place a trial specta-

cle near add lens in front of one eye and then the other while

the distance refractive error correction is in place for both

eyes. Determine whether the patient functions best with the

near add lens over the right or left eye.

B. Refractive Error Method

For anisometropic corrections, it is generally best to fit the

more hyperopic (less myopic) eye for distance and the more

myopic (less hyperopic) eye for near.

C. Visual Demands Method

Consider the patient's occupation during the eye selection

process to determine the critical vision requirements. If a

patient's gaze for near tasks is usually in one direction

correct the eye on that side for near.

Example:

A secretary who places copy to the left side of the desk will

usually function best with the near lens on the left eye.

3. Special Fitting Considerations

Unilateral Lens Correction

There are circumstances where only one contact lens is

required. As an example, an emmetropic patient would only

require a near lens while a bilateral myope may require only

a distance lens.

Example: A presbyopic emmetropic patient who requires a

+1.75 diopter add would have a +1.75 lens on the near eye

and the other eye left without a lens.

A presbyopic patient requiring a +1.50 diopter add who is

-2.50 diopters myopic in the right eye and -1.50 diopters

myopic in the left eye may have the right eye corrected for

distance and the left uncorrected for near.

4. Near Add Determination

Always prescribe the lens power for the near eye that pro-

vides optimal near acuity at the midpoint of the patient's

habitual reading distance. However, when more than one

power provides optimal reading performance, prescribe the

least plus (most minus) of the powers.

5. Trial Lens Fitting

A trial fitting is performed in the office to allow the patient to

experience monovision correction. Lenses are fit according

to the directions in the general fitting guidelines.

Case history and standard clinical evaluation procedure

should be used to determine the prognosis. Determine

which eye is to be corrected for distance and which eye is to

be corrected for near. Next determine the near add. With trial

lenses of the proper power in place observe the reaction to

this mode of correction.

Immediately after the correct power lenses are in place, walk

across the room and have the patient look at you. Assess

the patient's reaction to distance vision under these circum-

stances. Then have the patient look at familiar near objects

such as a watch face or fingernails. Again assess the reac-

tion. As the patient continues to look around room at both

near and distance objects, observe the reactions. Only after

these vision tasks are completed should the patient be asked

to read print. Evaluate the patient’s reaction to large print

(e.g. typewritten copy) at first and than graduate to news

print and finally smaller type sizes.

After the patient’s performance under the above conditions

are completed, tests of visual acuity and reading ability

under conditions of moderately dim illumination should be

attempted.

An initial unfavorable response in the office, while indicative

of a guarded prognosis, should not immediately rule out a

more extensive trial under the usual conditions in which a

patient functions.

6. Adaptation

Visually demanding situations should be avoided during the

initial wearing period. A patient may at first experience some

mild blurred vision, dizziness, headaches, and a feeling of

slight imbalance. You should explain the adaptational symp-

toms to the patient. These symptoms may last for a brief

minute or for several weeks. The longer these symptoms

persist, the poorer the prognosis for successful adaptation.

To help in the adaptation process the patient can be advised

to first use the lenses in a comfortable familiar environment

such as in the home.

Some patients feel that automobile driving performance may

not be optimal during the adaptation process. This is partic-

ularly true when driving at night. Before driving a motor

vehicle, it may be recommended that the patient be a

passenger first to make sure that their vision is satisfactory

for operating an automobile. During the first several weeks

of wear (when adaptation is occurring), it may be advisable

for the patient to only drive during optimal driving conditions.

After adaptation and success with these activities, the patient

should be able to drive under other conditions with caution.

7. Other Suggestions

The success of the monovision technique may be further

improved by having your patient follow the suggestions

below.

– Having a third contact lens (distance power) to use when

critical distance viewing is needed.

– Having a third contact lens (near power) to use when

critical near viewing is needed.

– Having supplemental spectacles to wear over the mono-

vision contact lenses for specific visual tasks may

improve the success of monovision correction. This is

particularly applicable for those patients who cannot meet

state licensing requirements with a monovision correction.

– Make use of proper illumination when carrying out visual

tasks.

Success in fitting monovision can be improved by the

following suggestions.

– Reverse the distance and near eyes if a patient is having

trouble adapting.

– Refine the lens powers if there is trouble with adaptation.

Accurate lens power is critical for presbyopic patients.

– Emphasize the benefits of the clear near vision in straight

ahead and upward gaze with monovision.

*The decision to fit a patient with a monovision correction

is most appropriately left to the eye care professional in

conjunction with the patient after carefully considering the

patient's needs.

*All patients should be supplied with a copy of the

BAUSCH & LOMB

SofLens

59 (hilafilcon B) Visibility

Tinted Contact Lens Patient Information Booklet.

HANDLING OF LENSES

When lenses are dispensed, the patient should be provided

with appropriate and adequate instructions and warnings for

lens handling. The eye care professional should recommend

appropriate and adequate procedures for each individual

patient in accordance with the particular lens wearing schedule.

For complete information concerning the care, cleaning and

disinfection of contact lenses refer to the BAUSCH & LOMB

SofLens

59 (hilafilcon B) Visibility Tinted Contact Lens

Patient Information Booklet.

CARE FOR A STICKING (NONMOVING) LENS:

If the lens sticks (stops moving), the patient should be

instructed to use a lubricating or rewetting solution in their

eye. The patient should be instructed to

not use plain water,

or anything other than the recommended solutions. The

patient should be instructed to contact the eye care

professional if the lens does not begin to move upon

blinking after several applications of the solution, and to

not attempt to remove the lens except on the advice of the

eye care professional.

CARE FOR A DRIED OUT (DEHYDRATED) LENS:

If a soft, hydrophilic contact lens is exposed to air while off

the eye, it may become dry and brittle and need to be re-

hydrated. If the lens is adhering to a surface, apply the

recommended rinsing solution before handling.

To rehydrate the lens:

• Handle the lens carefully.

• Place the lens in its storage case and soak the lens in a

recommended rinsing and storing solution for at least 1

hour until it returns to a soft state.

• Clean lens first, then disinfect the rehydrated lens using

a recommended lens care system.

• If after soaking, the lens does not become soft, if the

surface remains dry, DO NOT USE THE LENS UNTIL IT

HAS BEEN EXAMINED BY YOUR EYE CARE

PROFESSIONAL.

REPORTING OF ADVERSE REACTIONS:

All serious adverse experiences and adverse reactions observed in

patients wearing BAUSCH & LOMB

SofLens

59 (hilafilcon B)

Visibility Tinted Contact Lenses or experienced with the lenses

should be reported to:

Bausch & Lomb Incorporated

Rochester, New York 14609

Toll Free Telephone Number

In the Continental U.S., Alaska, Hawaii

1-800-828-9030

In New York State In Canada

1-800-462-1720 1-888-459-5000

HOW SUPPLIED:

Each sterile (STERILE) lens is supplied in a plastic, blister package

containing a saline solution. The container is marked with the manu-

facturing lot number of the lens (LOT), diopter power (F´

), diameter

and expiration date ( ).

Bausch & Lomb and SofLens are registered trademarks of Bausch & Lomb

Incorporated.

Rochester, NY 14609 Printed in U.S.A. 8015600

U.S. Patents 6,347,870; 6,044,966 and 4,997,897 and foreign patents.

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PACKAGE INSERT/

FITTING GUIDE

CAUTION:

Federal (USA) Law restricts this device to

sale by or on the order of a licensed

practitioner.

(hilafilcon B)

Visibility Tinted Contact Lenses

for Daily Wear

1 2 3 4 5 6 7 8 9

PACKAGE INSERT/ 1
FITTING GUIDE 1

Résumé du contenu

Page 1 - FITTING GUIDE

and individual tear composition may cause slightchanges in fitting characteristics.c. Allow any increase in tear flow to subside beforeevaluating the

Page 2

IMPORTANT:This package insert has been developed to provide practi-tioners with information covering characteristics of theBAUSCH & LOMB®SofLens®5

Page 3

IMPORTANT:This package insert has been developed to provide practi-tioners with information covering characteristics of theBAUSCH & LOMB®SofLens®5

Page 4

IMPORTANT:This package insert has been developed to provide practi-tioners with information covering characteristics of theBAUSCH & LOMB®SofLens®5

Page 5

IMPORTANT:This package insert has been developed to provide practi-tioners with information covering characteristics of theBAUSCH & LOMB®SofLens®5

Page 6

and individual tear composition may cause slightchanges in fitting characteristics.c. Allow any increase in tear flow to subside beforeevaluating the

Page 7

and individual tear composition may cause slightchanges in fitting characteristics.c. Allow any increase in tear flow to subside beforeevaluating the

Page 8

and individual tear composition may cause slightchanges in fitting characteristics.c. Allow any increase in tear flow to subside beforeevaluating the

Page 9

and individual tear composition may cause slightchanges in fitting characteristics.c. Allow any increase in tear flow to subside beforeevaluating the

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Bausch-lomb SofLens 59 Contact Lenses Manuel d'utilisateur

Naviguer en ligne ou télécharger Manuel d'utilisateur pour Santé et hygiène Bausch-lomb SofLens 59 Contact Lenses. Bausch & Lomb SofLens 59 Contact Lenses User Manual Manuel d'utilisatio

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