Soflex OverNight English Booklet

8/13/2019 Soflex OverNight English Booklet

1/17


2/17

1

Soflex OverNight Lens

Orthokeratology

This means the adaptation, elimination or decrease of the refractive adjustment with theuse of contact lenses. Contact lenses are used to restabilize the cornea and to decreasethe shortsightedness and astigmatism of the eye. The process is comparable toorthodontic straightening of teeth, with a difference: while teeth remain strengthened foran indefinite period, the cornea, being elastic, returns quickly to its original form. Thelens is worn during the night and taken off in the morning. Correct vision is achievedwith regular use, with no need for glasses or contact lenses during the day.

Attributes of Suitable Clients

prescription:spherical 0.75 to 5.00 DS

cylinder up to 1.25 DS (WTR)up to 0.75 DS (ATR)

corneal cylinder

healthy physiological condition of the eye

regular tear quantity

no use of drugs/medicines

good motivation

ability to adapt to a regular daily routine

Fitting stages

comprehensive examination of the eye using a slit lamp

tear quality and quantity diagnosis spectacles prescription

corneal topographer test results to be saved as original data

Lens Orders

Fill out Soflex order form No 3 with the following information (see sample at end ofdocument).

spectacles prescription: SPH, CYL, AXIS

cornea details: horizontal radius (Rh); vertical radius(Rv); vertical radius axis (V-Axis)

corneal eccentricity (EEC)

vertical iris diameter (VID) pupil size

target of the SPH power (usually plano)


3/17

2Soflex OverNight Lens

Soflex OverNight Lens Structure

SPH CYL AXIS Rh Rv VER.AXIS

ECC VID PUPILSIZE

SPHTARGET

R -2.50 -1.25 10 44.29 46.17 100 0.36 11.5 4.50 0.00L -2.25 -0.75 170 44.12 45.86 80 0.36 11.5 1.50 0.00

Example data

The base curve of the lens has four main areas:

Back Optic Zone Radius:an area with a diameter of 6.0 mm, with a radius flatter than thecorneal radius, with the value of the required refractive adjustment plus 1.00 diopter.In the example: BC=8.27

Alignment/Fitting Curve:designed to hold the lens on the periphery of the cornea. Thearea has to be in tangent with to the periphery of the cornea. Therefore, it is essential to

measure the eccentricity of the cornea.The width of the alignment/fitting curve is 1.0 mm.In the example: 7.57 mm, width 0.5 mm; 7.98 mm, width 0.5 mm.

Reverse Curve: Calculated using special software, this curve links the Back Optic ZoneRadius and the Alignment/Fitting Curve.In the example: 7.27 mm, width 1.0 mm.

Peripheral Curve:The structure of the lens edge allows a regular tear flow underneath thelens, providing comfort and easing removal of the lens from the eye.In the example: 10.27 mm, width of 0.3 mm.

In total, the lens diameter is 10.60 mm.


4/17


Physiological Process on the Cornea

During sleep, the pressure of the eyelid on the lens

causes capillary pressure of the tears on the center of thecornea. This pressure transfers epithelial cells from thecenter to the periphery. The pressure is released at theperiphery, causing the shape of the cornea to flatten(see figure no. 1).The width of the moved layer is expressed by theMunnerlyn formula:

(Optical Zone Dia) x Refractive Error x 10003

The result is measured in microns.

The process has two phases:1. The settling process lasts between 10 to 30 days.

During this period, the quality of vision may varyon a daily basis: some days, vision will beaccurate, and other days, visual quality maydecrease.

2. Stabilization and conservation occurs during sleep.When lenses are worn all night long, there is noneed for adjustment during the day. The aim is toreduce the number of nights during which thelenses are worn, while retaining accurate vision

over several days. Figure 1

Before Beginning the Process

During the Process


5/17


Soflex OverNight Fitting

Careful selection of the client is important for the success of the procedure.

High motivation and readiness to compromise slightly on the quality of the vision willsignificantly increase the success rate.The client must be informed of alls advantages and disadvantages of the method, and beaware of amount of time required for the fitting and the follow-up stages.

Ordering Soflex OverNight Lenses

Fill out Soflex order form no. ____ with the following information (see sample at end ofdocument):

spectacles prescription: SPH, CYL, AXIS

corneal details: horizontal radius (Rh); vertical radius (Rv); vertical radius axis (V-Axis)

corneal eccentricity (EEC)

vertical iris diameter (VID)

pupil size

SPH target power (usually plano)

The data received by Soflex is transferred to special computer software, which providesproduction data to CNC-activated cutting machines. Lenses are produced according toindividual client parameters. For practitioner and client convenience, the right and leftlenses are produced from differently-tinted raw material: rightViolet, leftIce Blue.Lenses are delivered with a form listing the clients parameters as provided by thepractitioner, as well as the lens production date.

Dispensing Lenses to the ClientInvite the client to receive the lenses at a one-hour afternoon session. Friday is preferable, so awork/study-free weekend can be used as initiation time. The client must also be available for ameeting the following morning.

1. Important! Put hydrating solution on the concave side of the lenses, to improvecomfort and prevent bubbles from forming.

2. Insert the lenses.

3. Ask the client to sit with head held high and to stare downwards for a fewminutes, until the lenses are comfortable.

4. About five minutes after insertion, using the slit lamp, checklens centration and movement (1.01.5 mm at every eyelid closure).

5. Check that vision with the lenses is correctat least 6:7:5.


6/17


6. Conduct a fluorescein test. The

pictures should be similar to figure 2(Bulls Eye). Trapped air bubbles,which will disappear during thefirst night, may be seen (see figure 3).

7. Remove the lenses.

8. Important! Instruct the client oncorrect insertion, removal andcare of the lenses (see detailedinstructions on pages 1012).

9. Instruct the client to sleep withthe lenses that night and wearthem until arrival at the clinic thenext morning.

IMPORTANT! The client must puthydrating drops in the eyes uponawakening.

The morning after dispensing the lenses,carry out the following steps:

1. Vision test: Vision should be correct,at least 6:7:5.

2. Slit lamp test: Lenses should becentrated and should move 1 mm.There should be no unusual clinicalfindings.

3. Fluorescein test: The picture shouldresemble figure 4 (Bulls eye)

4. Remove the lenses.5. Vision test: Vision after the first

night will possibly measure from6:6 up to 6:7:5 for a short time.

Figure 3

Figure 2

>3.5 mm

>5.0 mm

Figure 4


7/17


6. Corneal topographer measurement: Thepicture should resemble figure 5.

For follow-up purposes, save L+Rpictures under the clients name.

7. Schedule follow-up visits after thefollowing intervals: two days, onemonth, three months, and everythree months afterwards. Repeat stepsone to six during each visit.

IMPORTANT! Remind the client to hydratethe eyes upon awakening and to remove

the lenses a few minutes afterwards.

Figure 5

After the First Night

Figure 6

After One Week

Figure 7

Optimal Topography

>6.0mm

Figure 8

Fluorescein Picture

Figure 9

Optimal Fluorescein Picture


8/17

7


Troubleshooting

No. Problem Factor/Cause Solution1 Low-riding Lens alignment curve (AC)

too long release alignment curve(AC) by 10 microns

2 High-riding Lens AC too flat upper eyelid toostretched

tighten AC by 10microns

increase thickness oflens by 25%

3 Side-riding Lens eyelid tension too high corneal cylinder ATR

cornea not symmetricbetween nasal andtemporal sides

increase width of secondAC

clean residue off lens

4 Central Island AC too long corneal cylinder stillpresent

if lens is centrated,flatten AC by 5 to 10microns

if lens is not centrated

(see problemsno.1, 2, 3),centrate lens, checkwhether problempersists, and fixaccordingly

if cylinder is still notfixed, flatten BCaccording to findings


9/17

8


No. Problem Factor/Cause Solution

5 Central Staining lens not clean BC too flat low oxygen supply tocornea

mainly mechanicalirritation, obvious onfluorescein picture

Clean lenses thoroughly(see lens careinstructions)

steepen BC by 10microns

order lens made of amaterial with a higheroxygen permeability

.

6 Vaulting reverse curve toosteep

AC too long

reduce lens sag by 15microns

take care not to changethe centration of thelens as a result of thisreduction

7 Air Bubbles insufficient tear flowunder lens

AC too long

if length and arch of airbubble is less than 45and there is no staining,remind client to fill lenswith hydrating solution

before insertion if staining is present and

air bubble is presentafter two or three days,exchange lens with onehaving AC flatter by 5to 10 microns

8 Lens Imprint lens not centrated AC too long during fluorescein

test, marks from thelens can be seenon cornea

centrate using a/mmethods

if lens is already

centrated, release ACby approx. 10 microns decrease diameter


10/17

9


No. Problem Factor/Cause Solution

9 Under-responsiveness SPH target power too

low lens creates vaulting some clients

require a longeradjustment period, as aresult of lower eyelidpressure, or of a lessflexible corneacommon amongformer contact lens(especially GPL)

wearersA longer period shouldbe allowed beforechanging lens data.

enlarge base radius to

add approx.0.50 to 0.75 dioptersto the SPH target power

In case lens createsvaulting, fix this(seeproblem no. 6) andcontinue tests.

If these changes do nothave any effect, theclient may be unsuitablefor this type of process.

10 Reduced Holding Time lens not centrated reverse curve toowide

low level vaulting

centrate lens change to a lens withwider optic area(see problem no. 6)

The cornea may benaturally very flexible,

and may not hold itsshape for the duration ofone full day.

11 Ghosting at Night In low light, the iriswidens, and a shadow isseen

change to wider opticarea (6.2 to 6.4 mm)


11/17

10


Lens Care

Care of these lenses is identical to care of gas permeable lenses (GPL).Before handling contact lenses, wash your hands and dry them thoroughly.It is advisable to have the lenses cleaned at a laboratory every three months.

1. Wet the eye with hydrating solution a few minutes before removing the lensfrom the eye.

2. Remove the lens and place it in the palm of the hand.

3. Put a few drops of cleaner under and in the curve of the lens.

4. Rub both sides of the lens with the index finger, for approx. 2030 secs.

5. Clean the edge of the lens with a cotton-swab stick moistened with a few drops ofcleaner.

6. Rinse the lens thoroughly in saline solution.

7. Immerse the lens in conditioner in a clean case.

8. Repeat the process with the second lens.


12/17

11


Inserting the Lenses

1. To avoid confusion, always start with the same lens!

2. Take the first lens out of the case.

3. Rinse the lens in saline solution.

4. Check that there is no dirt residue on the lens.

5. Put a few drops of hydrating solutions in the curve of the lens.

6. Balance the lens on the index finger, and with the middle finger of the same hand,pull the bottom eyelid downwards.

7. With the index or middle finger of the other hand, lift the upper eyelid.

8. Gently place the lens on the cornea.

9. Slowly release the eyelid and blink a few times. The lens should position itself onits own.

10. Check that the position and eyesight are correct.

11. Repeat the process with the second lens.

In case of incorrect vision:

If the lens is not positioned correctly, remove and reinsert it.

If there is dirt residue, remove and clean the lens, and reinsert it.

If the lenses were inadvertently switched, remove both lenses, switch them,and reinsert them.


13/17

12


Removing the Lenses

Approximately four minutes before removing the lenses, wet them with afew drops of hydrating solution, and make sure they move freely in the eyes.It is advisable to remove the lenses while sitting at a table spread with a clean towel,leaning on the table, facing downwards toward the towel.

Choose among three methods of lens removal:

Eyelid Method1. Position the index finger on the external corner of the eye. Pull the skin outwards and

slightly downwards, keeping the eye open.

2. Blink rapidly. The lens will be pushed out by the eyelid and will fall onto the cleantowel.

Fingers Method1. Position the tip of one index finger in the center of the edge of the upper eyelid.

Position the tip of the other index finger in the center of the edge of the lower eyelid.

2. Press lightly on the upper eyelidthe lens will rise. Next, push the lower eyelidupwardsthe lens will come out and fall onto the clean towel.

DMV Rubber Pump MethodDANGER! Improper use of this method can cause damage to the cornea.1. Wet the tip of the pump with immersion liquid.

2. Using a mirror, position the center of the pump on the surfaceof the lensthe pump will stick to the lens.

3. Gently pull the pumpthe lens will easily come off, attached to the pump.


14/17

13


FAQ

What is Orthokeratology?

This means the adaptation, elimination or decrease of the refractive adjustment bythe use of contact lenses. Contact lenses are used to restabilize the cornea and todecrease the shortsightedness and astigmatism of the eye. The process iscomparable to orthodontic straightening of teeth, with a difference: while teethremain straightened for an indefinite period, the cornea, being elastic, returnsquickly to its original form. The lenses are worn during the night and taken off inthe morning. Correct vision is achieved with regular use, with no need for glassesor contact lenses during the day.

Why wear Soflex OverNight lenses?

no need to wear contact lenses or glasses during the day

ideal for active people or for those who work in difficult environments stabilization of short-sightedness

Is the Ortho K suitable for everybody?The lenses are suitable for powers of up to 4.50 spherical dioptersand up to 1.00 cylindrical diopters. For higher prescriptions it is possible toreduce the power slightly.The lenses are unsuitable for irregularly flat or convex corneas.Unknown factors such as cornea complexity and flexibility can affect the level ofadjustment.Although success rate is very high, 100% success cannot be promised.

What is the procedure?

First of all, a complete eye evaluation has to be carried out, including cornealtopography and a vision check. This allows the optometrist to evaluate the healthof the eye and cornea, and the suitability of the client.The client receives a pair of Soflex OverNight lenses made of a flexible materialwith very high oxygen permeability, to be worn during the night. The morningafterwards, the client returns for an eye examination and an evaluation of thechanges in the cornea.A week later, another examination and cornea evaluation is carried out.Most significant change occurs during the first few days, while final stabilizationof the cornea occurs at a slower pace, and continues during a period of up to three

months, depending on the level of myopia.Wearing time depends on several factors, but the ultimate aim is for the client towear the lenses every two or three nights, and to see correctly during thefollowing days without the need for glasses or contact lenses.


15/17

14


What are the advantages of Ortho K?

correct vision with no glasses or contact lenses no need for surgery

completely reversible process painless risk free lenses may be worn during the day or night use of contact lenses has a long, successful record no age limit

What are the disadvantages of Ortho K?

stabilization occurs only after three months and numerous visits to theoptometrist

success is not guaranteed

optometrists instructions must be strictly followed

Is Ortho K preferable to laser eye surgery?

Definitely! reversible process (unlike surgery!) painless no shadow vision no damage to Baumans layer eventual changes in vision can be easily handled less expensive treatment with drugs is unnecessary

Is this a revolutionary new treatment?

Yes and no. The principles of the method were determined in 1962. However,todays computer technology, oxygen-permeable raw materials and high-precisioninstruments, such as the corneal topographer, promise a higher success rate thanever.

Is the treatment safe?

This treatment has helped many people become independent of glasses andcontact lenses while incurring no damage to the eyes. In contrast withkeratotomy, there is no damage to the eyes or corneas such as scarring, whichmight cause problems with night vision. However, contact lenses must be

properly maintained, to ensure that the eyes remain healthy.

Is Ortho K suitable for me?

The treatment suits almost everyone. The optometrist will be able to determineyour suitability.

Will I need to wear glasses or contact lenses?

Once the prescription is stabilized, the lenses will ensure continued stability.Therefore, there is no need for glasses or contact lenses during the day. Clientswho use reading glasses will still need them.


16/17

15


How long does it take to see correctly without glasses?

The change occurs from within a few hours to up to a few days. The amount oftime needed for stabilization varies from client to client.

Is it possible to match lenses to eyes which have gone through a keratotomy

procedure?

Yes. In most cases, the Ortho K can help after RK surgery , and is also beneficialfor astigmatism that can result from RK surgery. However, Ortho K does not healscars and does not help with impaired night vision following RK.

Children might experience changes in prescription. Can Ortho K help?Yes, the treatment can slow or halt the progressof myopia and otherrefractive problems, offering a more optimistic future to younger clients.

What is the cost of Ortho K treatment?

In general, Ortho K is less expensive than laser surgery (PRK).Cost is determined according to the complexity of the case.In simple cases, the price ranges between $1000 and $1500, according to thelength of treatment and the number of lenses changed.Prices vary from clinic to clinic. Your optometrist will inform you of the full costof treatment.

Is the treatment permanent?

After optimum results have been achieved with initial treatment, maintenancelenses are distributed. The maintenance lenses stabilize the prescription and mustbe used on a regular basis and according to the optometrists instructions, or the

prescription will return to its original status. The maintenance lenses may beused during the day or night, at the clients convenience.


17/17

3.Soflex Order Form No

Soflex OverNight Lenses Order Form

Name of the clinic Date:

Client Name Order No.:

Fill in the following table in case of a new client order:

It is advised to send a topographic figure to: [email protected]

Comments:

A topographic figure was sent under the name: ________________________________Yes/No

Order for a returning client or a lens correctionMark previous lens details for each eye separatelyFor a lens correction you must send a topographic figure showing how the lens sits on the cornea,to e-mail: [email protected] comments regarding required correction and description of the florescein figure.

Lens Details

Basis Power Diameter

Delivery Note orBarcode No.

Delivery date

R

L

Comments:

A topographic figure was sent under the name: ________________________________Yes/No

Ordered by: ________________________________________________

SPH CYL AXIS Rh RvVER.AXIS

ECCIRISDIA.

PUPILDIA.

SPHTARGET

R

L

Documents

Soflex OverNight English Booklet