Location: Zoom
Meeting Called by: Pre-Optometry Club
Duration: 1 hour
Guest Speaker: Dr. Nicky Lai
- Associate professor of clinical optometry
- Chief, Contact Lens Service
- OD, MS 2003 OSU Optometry
- lai.102@osu.edu
Dr. Lai is originally from California, and he attended UCLA for his undergraduate degree. He wanted to move out of California to experience new ways of life, so he interviewed for Ohio State Optometry. He felt very welcomed when he came to Ohio State and knew he would have a good support system as he moved across the country. After optometry school, he planned to move back to California, but he began working with a faculty member on a research project focused on eye movement. Although he realized research wasn’t for him, he appreciated his experience in this project, as it gave him insight into the field and was a good segway into academia and teaching. During his undergraduate career, he tutored many students and worked as a teaching assistant. Dr. Lai loved Ohio State’s curriculum because he was able to get a feel for every specialty, but he particularly was fascinated by contact lenses. Now, he works as the Chief of Contact Lens Services, in which he manages the clinic, helps establish policies, and disseminates information as new technology and advancements come about. Dr. Lai really enjoys being able to not only interact with patients but also teach his students at the same time in the exam room.
Types of contact lenses
- Elective – refractive correction (near- or farsighted .. may just not want to wear glasses, so that’s why they’re referred to as “elective”)
- Medically Necessary (patients cannot function visually without these lenses)
- Myopia management
- Therapeutic lenses
- Drug delivery (allergies make it difficult to wear contact lenses)
- Glaucoma monitoring
- Amniotic membrane
Contact lens
1. Soft lenses (hydrogel; silicone hydrogel)
- Water content
- Silicone is an element that allows more oxygen transmission
2. Gas permeable (“hard” lens; GP lens)
- 50–60% of people have refractive errors
- Contact lenses bend light, so the light can focus on the retina
- Every time you blink, your tears creep under the lens
- Must account for the power of lens but also the tear lens
Myopia, Hyperopia
- Nearsighted vs farsighted
- Can correct really high prescriptions (i.e. -20,+20)
Astigmatism (Not all of what you see is in focus at the same time)
- Lenses to correct astigmatism have to sit on the eye and in the exact same spot every time or else it will move around, causing the patient to not be able to see.
- Don’t want the lens to be glued onto eye (should be floating on eye and moving freely)
- Some lenses are thicker on the bottom, so every time you blink, lens goes back into place
Presbyopia (Inability to see up close)
- Multifocal lenses; see far away and up close at the same time (Line going across lens)
- Bifocal contact lens
- When patient looks down, lens slides up a little and the patient can see out of bottom part of contact lens
Astigmatism and presbyopia lenses were considered “specialty lenses” for a while
Lens wear compliance is so important
- Patient abusing lens?
- Not cleaning/disinfecting?
- Not using as they should?
- Smoking?
- Buying contacts online is a risk factor (habit; if something is wrong with lens fit, no one is catching it; not going to optometrist regularly)
- Fungal infection if a patient sleeps in contacts?
- Optometrists like to encourage a daily disposable lens to ensure patients are wearing clean lenses everyday
Medically Necessary contacts may be able to assist in patients with corneal disease
- Keratoconus (we don’t really know why it happens; genetics?)
- Cornea gets thin and bulgy
- Supposed to refract light, but not consistent (light won’t focus well)
- May get scarring on cornea
- Cornea should be clear, but as the tissue deteriorates, cornea may not be clear
- May need a corneal transplant, but may be able to get medically necessary contact lenses (Tears fill in behind the lens and correct the irregularities)