UltraHealth Initial Fit & Dispense
- How is the first UltraHealth lens selected?
How is the first UltraHealth lens selected?
You will always start with the 250 Vault lens in the Flat skirt in the Diagnostic Set. Insert the lens with Fluorescein and Adjust fit from there.
Apical Bearing – Increase the Vault
Apical Clearance – Decrease the Vault
- How do I insert the lenses?
How do I insert the lenses?
UltraHealth lenses must be inserted with a full bowl of saline solution. This can be achieved by holding the lens with 2 or 3 fingers or using an insertion tool to balance the lens.
- How long should I let the lenses settle before assessing the fit?
How long should I let the lenses settle before assessing the fit?
Allow the lenses to settle for 3-5 minutes to allow excess fluorescein to dissipate. If you see apical bearing after 1 minute remove lens and increase the vault.
- How much movement should I expect to see?
How much movement should I expect to see?
UltraHealth lenses will typically move about .5 -1.0 mm – about like a soft lens.
- Do I need to use fluorescein to assess the fit?
Do I need to use fluorescein to assess the fit?
Yes, because we are fitting Irregular Corneas with the UltraHealth lenses it is necessary to achieve full clearance under the Vault and Under the Inner Landing Zone. You may use an OCT instrument to measure the clearance as well.
- How do I fit the skirt?
How do I fit the skirt?
Once you achieve the proper clearance in the vault; observe the Inner Landing Zone to determine skirt curve. Use flattest skirt possible that provides slight clearance in the Inner Landing Zone (ILZ) and that has no wrinkling at the skirt edge.
- How do I find final lens power?
How do I find final lens power?
Once you have the correct fit – over-refract to find your final lens power. Once you have over-refracted one lens your over-refraction will be the same for each lens. Add the over-refraction to the power of the diagnostic lens you wish to order.
- Should I recommend a wear schedule?
Should I recommend a wear schedule?
You may recommend a tiered wear schedule for the patient’s first week of wear.
- What solutions are recommended for use with UltraHealth lenses?
What solutions are recommended for use with UltraHealth lenses?
Disinfection Systems: Use chemical (not heat) disinfection systems (Multi-Purpose or Hydrogen Peroxide* solutions), as recommended by your eye care professional.
Daily Cleaner: The standard of care for contact lenses recommends using a daily cleaner approved for soft contact lenses.
Rewetting Drops: If needed, use rewetting drops approved for soft contact lenses, as directed by your eye care practitioner.
*In some patients the tear chemistry may react with the hydrogen peroxide to cause a permanent white ring at the junction of the rigid center and soft skirt. This ring does not affect vision or comfort.
UltraHealth FC Initial Fit & Dispense
- How is the first UltraHealth FC lens selected?
How is the first UltraHealth FC lens selected?
Start with 255 Vault lens in UltraHealth FC diagnostic set. Appropriate fit is determined by increasing or decreasing vault, in 100 micron increments, to find first corneal touch under the vault area. Order first lens 50-100 microns over first touch.
- How do I insert the lenses?
How do I insert the lenses?
UltraHealth FC lenses must be inserted filled to the brim with a saline solution and fluorescein. You may use a DMV inserter or “tripod method’, balancing the lens on 3 fingers.
- How long should I let the lenses settle before assessing the fit?
How long should I let the lenses settle before assessing the fit?
If initial vault bearing observed: remove lens and insert lens with vault increase of 100 microns.
If initial vault clearance observed: let lens settle for 3-5 minutes to allow excess fluorescein to dissipate. If still clearance, remove lens and insert lens with vault decrease of 100 microns
- How much movement should I expect to see?
How much movement should I expect to see?
UltraHealth FC lenses will typically move about .5 -1.0 mm – much like a soft lens.
- Do I need to use fluorescein to assess the fit?
Do I need to use fluorescein to assess the fit?
Yes, because we are fitting UltraHealth FC lenses on Irregular Corneas, fluorescein is a valuable tool in identifying proper lens/cornea relationship. Desired fluorescein pattern will show 50-100 microns vault clearance with feather touch in the Inner Landing Zone (ILZ). You may use an OCT instrument to measure clearance, as well.
- How do I fit the skirt?
How do I fit the skirt?
Once you achieve proper clearance in vault; observe the Inner Landing Zone (ILZ). If medium skirt provides slight clearance/feather touch in the ILZ, and the skirt has no wrinkling at the skirt edge, you are ready to order.
- How do I find final lens power?
How do I find final lens power?
All lenses in the UltraHealth FC diagnostic set are calibrated to take same OR. Once you have determined lens vault – simply over-refract to find final lens power. Add the over-refraction to the power of the diagnostic lens you wish to order.
*Note: you cannot use an over-refraction done on an UltraHealth FC lens to calculate a standard UltraHealth lens order, and vice versa.
- Should I recommend a wear schedule?
Should I recommend a wear schedule?
You may recommend a tiered wear schedule for the patient’s first week of wear.
- What solutions are recommended for use with UltraHealth FC lenses?
What solutions are recommended for use with UltraHealth FC lenses?
Disinfection Systems: Use chemical (not heat) disinfection systems (Multi-Purpose or Hydrogen Peroxide* solutions), as recommended by your eye care professional.
Daily Cleaner: The standard of care for contact lenses recommends using a daily cleaner approved for soft contact lenses.
Rewetting Drops: If needed, use rewetting drops approved for soft contact lenses, as directed by your eye care practitioner.
*In some patients the tear chemistry may react with the hydrogen peroxide to cause a permanent white ring at the junction of the rigid center and soft skirt. This ring does not affect vision or comfort.
UltraHealth & UltraHealth FC Follow-Up Visit
- What am I looking for at the follow-up visit?
What am I looking for at the follow-up visit?
Some lens movement and patient comfort
- Verify movement on blink or with push-up test.
- In the absence of a dry eye diagnosis, patients should get a full day of comfortable wear with most wearing comfortably between 8 and 14 hours.
Corneal health
- Perform a slit lamp evaluation to assess the cornea and epithelium for signs of insult.
- If the patient complains of discomfort when wearing the lenses, use fluorescein to check the cornea for SPE and/or assess the lens fit.
Check acuities
- Distance visual acuity should be acceptable to the patient.
- What do I do if the patient reports discomfort at follow-up?
What do I do if the patient reports discomfort at follow-up?
Your patient should be able to comfortably wear UltraHealth or UltraHealth FC lenses for 8 to 14 hours each day. If that is not the case:
- Check for dry eye and treat any dry eye conditions.
- Check the lens fit to confirm adequate clearance under vault and ILZ.
- Consider a solutions reaction and recommend a hydrogen peroxide disinfection system if necessary.
- What do I do if vision is unacceptable at follow-up?
What do I do if vision is unacceptable at follow-up?
Confirm that the over-refraction is correct and that there is no residual astigmatism present. Adjust the lens power as necessary.
Confirm lenticular astigmatism by performing k-readings over the lenses.
- What do I do if my patient reports filming or fogging on the lens surface?
What do I do if my patient reports filming or fogging on the lens surface?
Lens filming or fogging may be caused by:
- A tight fitting lens
- Ensure the lens has adequate clearance under the vault and the ILZ.
- Ensure it’s not too much clearance in either place.
- Oil-based cosmetics
- Instruct patients to avoid all makeup, hand soaps and lotions containing oil.
- Oil-based cosmetics will permanently damage the plasma coating on the lens.
- Improper care
- Train patients to use a soft lens daily cleaner to clean their lenses each night.
- Patients that are prone to deposits may need to store their lenses overnight in Clear Care rather than a multi-purpose solution.
- Patients who are heavy protein depositors may use an enzymatic cleaner 1-2 times per week.
