Certified Paraoptometric Review Certified Paraoptometric ...texas.aoa.org/documents/tx/205 - VIRDEN...

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Certified Certified Paraoptometric Paraoptometric

ReviewReviewPart IIPart II

Stacie Layne Virden, O.D.Stacie Layne Virden, O.D.Therapeutic OptometristTherapeutic OptometristGlaucoma SpecialistGlaucoma Specialist

Certified ParaoptometricCertified Paraoptometric

Certified ParaoptometricCertified Paraoptometric

Abbreviated CPOAbbreviated CPO

A person who has attained national recognition A person who has attained national recognition via certification by demonstrating an via certification by demonstrating an understandingunderstanding of the concepts used in of the concepts used in optometric careoptometric care

The CPO has demonstrated competence by a The CPO has demonstrated competence by a didactic examination and is ondidactic examination and is on--thethe--job trained.job trained.

Certified Paraoptometric ExamCertified Paraoptometric Exam

How To StudyHow To Study

Become interactive with Become interactive with materialmaterial

flash cards*flash cards*www.aoa.orgwww.aoa.org

notesnotestape record notestape record notesstudy groupsstudy groups

Study environmentStudy environmentfloral scented candles or floral scented candles or potpourri facilitates potpourri facilitates learning (strange but true)learning (strange but true)wake up your body, wake wake up your body, wake up your mind up your mind -- walk, sit on walk, sit on edge of chairedge of chair


How To StudHow To Studyy

Study pace Study pace -- preview material, study, break, preview material, study, break, reviewreview

Do not study for more than 2 hours at a timeDo not study for more than 2 hours at a timeUse travel time to study Use travel time to study -- use tapesuse tapes


Test Taking TipsTest Taking Tips

Get plenty of rest the night Get plenty of rest the night before before -- important in this important in this meeting environment.meeting environment.

Arrive a little early for testArrive a little early for test--look for test room today.look for test room today.

A little anxiety is OK A little anxiety is OK -- it it makes us perform better.makes us perform better.

Know the time limit and be Know the time limit and be aware of time throughout the aware of time throughout the test. Manage your time.test. Manage your time.

Read the directions carefully.Read the directions carefully.

Make sure you know how to Make sure you know how to enter items on score sheet.enter items on score sheet.

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Test Taking TipsTest Taking Tips

Realize there may be Realize there may be questions you do not questions you do not know the answer to. know the answer to. There should not be There should not be many, but we tend to many, but we tend to dwell on them.dwell on them.

Your first impression for Your first impression for an answer is usually the an answer is usually the best.best.

Memory dump Memory dump -- at at beginning of test write beginning of test write down the facts you want down the facts you want to remember.to remember.

Make a mark at the Make a mark at the margin on questions you margin on questions you want to return to.want to return to.


Multiple Choice QuestionsMultiple Choice QuestionsEssentially are true/false questions arranged in Essentially are true/false questions arranged in groups.groups.

Only one alternative is totally correct.Only one alternative is totally correct.Eliminate obvious false choices.Eliminate obvious false choices.Of remainder, pick the alternative that answers most Of remainder, pick the alternative that answers most fully all aspects of the question.fully all aspects of the question.Only change your first answer if you have a very Only change your first answer if you have a very good reason good reason -- i.e. read questions incorrectly.i.e. read questions incorrectly.

A Little Anxiety Is OkayA Little Anxiety Is Okay

TriageTriage

TriageTriage

First point of contact between patient and health First point of contact between patient and health care providercare provider

StaffStaff’’s primary duty is to determine if the patient s primary duty is to determine if the patient has a true emergencyhas a true emergency

If so, how does it compare with what is already If so, how does it compare with what is already happening in the office, and how soon can we happening in the office, and how soon can we get the patient in for care?get the patient in for care?

TriageTriage

QUESTIONS TO ASKQUESTIONS TO ASK

What kind of problem are you having?What kind of problem are you having?How long has it been going on? (onset/duration)How long has it been going on? (onset/duration)Is it getting worse? (severity)Is it getting worse? (severity)Does it affect your vision? (associated symptoms)Does it affect your vision? (associated symptoms)Does anything make it better? (relief)Does anything make it better? (relief)

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HIPAAHIPAA

HIPAAHIPAA

What is HIPAA?What is HIPAA?

•• Health Information Portability & Accountability ActHealth Information Portability & Accountability Act

•• Defines penalties for healthcare providers who allowDefines penalties for healthcare providers who allowbreaches to patientsbreaches to patients’’ protected health informationprotected health information

•• Penalties increase significantly Spring 2010Penalties increase significantly Spring 2010

HIPAAHIPAA

HIPPA Regulations (Federal Law)HIPPA Regulations (Federal Law)State Laws may also existState Laws may also existDoDDoD Guidance (Military) also existGuidance (Military) also existAccounting of disclosures only applies to events Accounting of disclosures only applies to events after April 14, 2003after April 14, 2003

HIPAAHIPAA

““UseUse”” and and ““DisclosureDisclosure””

Use: the sharing, employment, application, Use: the sharing, employment, application, utilization, examination or analysis of Protected utilization, examination or analysis of Protected Health Information (PHI) within the covered Health Information (PHI) within the covered entityentityDisclosure: the sharing or release of PHI in any Disclosure: the sharing or release of PHI in any manner outside the covered entitymanner outside the covered entity

HIPAAHIPAA

Required DisclosuresRequired Disclosures

When the individual patient requests itWhen the individual patient requests itTo secretary of HHS to determine complianceTo secretary of HHS to determine compliance

HIPAAHIPAA

Office Privacy Act ResponsibilitiesOffice Privacy Act Responsibilities

Establish and maintain procedures consistent with the Privacy Establish and maintain procedures consistent with the Privacy ActActPrepare and publish notice of the existence and character of Prepare and publish notice of the existence and character of those systems consistent with guidance by GSAthose systems consistent with guidance by GSAEstablish reasonable administrative, technical, and physical Establish reasonable administrative, technical, and physical safeguardssafeguardsMaintain an account system of all disclosures for six yearsMaintain an account system of all disclosures for six yearsPermit individuals to have access to personal recordsPermit individuals to have access to personal recordsPermit individuals to request records amendmentsPermit individuals to request records amendments

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HIPAAHIPAA

HIPAA Privacy RuleHIPAA Privacy RuleThis rule overlaps Privacy Act of 1974This rule overlaps Privacy Act of 1974Individuals have the right to receive an accounting of Individuals have the right to receive an accounting of disclosures of PHI made by your office with the disclosures of PHI made by your office with the exceptions of:exceptions of:

TreatmentTreatmentPaymentPaymentHealthcare OperationsHealthcare Operations

Accounting must include disclosures made in the past Accounting must include disclosures made in the past six years of request datesix years of request date

HIPAAHIPAA

Minimum Necessary PrincipleMinimum Necessary Principle

Requires office to take Requires office to take reasonable steps to limit the use or reasonable steps to limit the use or

disclosure of, and request for, PHI to the disclosure of, and request for, PHI to the minimum necessary to accomplish minimum necessary to accomplish

intended purposeintended purpose

HIPAAHIPAA

Implementing StandardsImplementing Standards

Identify those in your office who need access to PHI to Identify those in your office who need access to PHI to do their jobdo their job

Front DeskFront DeskDoctorDoctor’’s Assistants AssistantCL techCL techOpticianOpticianInsurance billingInsurance billingOK, EVERYONE!OK, EVERYONE!

HIPAAHIPAA


Further identify anyone outside the office who Further identify anyone outside the office who may need accessmay need access

Ophthalmic Lens LabOphthalmic Lens LabSoft Lens ManufacturerSoft Lens ManufacturerGas Perm Lens ManufacturerGas Perm Lens ManufacturerFrame ManufacturerFrame ManufacturerInsurance CompaniesInsurance Companies

HIPAAHIPAA


Create policies and procedures for routine Create policies and procedures for routine disclosures to achieve purpose of disclosuredisclosures to achieve purpose of disclosure

Limit the PHI disclosed by developing criteriaLimit the PHI disclosed by developing criteria

Review requests on an individual basis against Review requests on an individual basis against criteriacriteria

HIPAAHIPAA

Considerations Prior to DisclosureConsiderations Prior to Disclosure

Patient notification before releasePatient notification before releaseMutually agreed upon alternative communicationsMutually agreed upon alternative communicationsMutually agreed upon authorizationsMutually agreed upon authorizationsPotential or serious threat or imminent danger to Potential or serious threat or imminent danger to

patient or publicpatient or publicAuthority of requestorAuthority of requestorMinimum amount of information necessary for purposeMinimum amount of information necessary for purposeCan information be deCan information be de--identifiedidentifiedDocumentation of releaseDocumentation of release

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HIPAAHIPAA

Requirements for Disclosure Request DocumentsRequirements for Disclosure Request Documents

Date of disclosureDate of disclosureName, address, and identity of requestorName, address, and identity of requestorBrief description of PHI to be disclosedBrief description of PHI to be disclosedBrief statement of the purpose of the disclosure that Brief statement of the purpose of the disclosure that reasonably informs the individual of basis for reasonably informs the individual of basis for disclosure or copy of written requestdisclosure or copy of written requestVerified identity of requestorVerified identity of requestor

HIPAAHIPAA

Elements of Valid AuthorizationsElements of Valid Authorizations

Description of used/disclosed informationDescription of used/disclosed informationName of person authorized to make requestName of person authorized to make requestName of person to whom the requested use or disclosureName of person to whom the requested use or disclosureAn expiration date An expiration date Signature of patient and dateSignature of patient and dateStatement that information may be subject to reStatement that information may be subject to re--disclosure by disclosure by the recipient, therefore, no longer protected under HIPPAthe recipient, therefore, no longer protected under HIPPAVerification of requesting partyVerification of requesting partyAuthorization must be written in plain EnglishAuthorization must be written in plain English

Prefixes, Suffixes, and Prefixes, Suffixes, and Root WordsRoot Words

Prefixes, Suffixes, Root WordsPrefixes, Suffixes, Root Words

Prefixes Prefixes Suffixes Suffixes Root words Root words Direction termsDirection termsO.D. O.D. -- O.S. O.S. -- O.U.O.U.

The Ophthalmic PrescriptionThe Ophthalmic Prescription


DiopterDiopter

Unit of measure for optical lenses. Unit of measure for optical lenses. Based on physics that proves that a 1 diopter lens will Based on physics that proves that a 1 diopter lens will focus parallel light at 1 meter.focus parallel light at 1 meter.Can be measured for plus Can be measured for plus lenses for farsightedness, lenses for farsightedness, or for minus lenses for or for minus lenses for nearsightedenessnearsightedeness

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-- 1 D1 D

+ 1 D+ 1 D

1 meter1 meter

1 meter1 meter


Components of a lens prescriptionComponents of a lens prescriptionSphere, cylinder, axisSphere, cylinder, axisAdd powerAdd powerPrismPrism

Ex. Ex. --4.00 4.00 –– 1.00 x 180 2 BI, 0.75 BU +2.251.00 x 180 2 BI, 0.75 BU +2.25--3.00 3.00 SphSph 2 BI, 0.75 BD +2.252 BI, 0.75 BD +2.25


LensometerLensometerInstrument used to measure the power in a lensInstrument used to measure the power in a lensMay be manual or automatedMay be manual or automated Ophthalmic LensesOphthalmic Lenses

Ophthalmic LensesOphthalmic Lenses

Types of LensesTypes of Lenses

Single visionSingle visionSphericalSphericalPlanocylindricalPlanocylindricalSpherocylindricalSpherocylindricalMultifocalMultifocal

Bifocal, trifocal, progressive additionBifocal, trifocal, progressive addition


Trifocal Lenses Trifocal Lenses (Executive)(Executive)

7mm7mm

17mm17mm

28mm28mm

Bifocal Lenses (FTBifocal Lenses (FT--28, 28, DD--28)28)

Progressive Addition Lenses Progressive Addition Lenses

Aberration ZonesAberration Zones

Near ViewingNear ViewingZone Zone

Intermediate Intermediate Viewing Zone Viewing Zone

Distant Viewing ZoneDistant Viewing Zone

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Lens MaterialsLens Materials

GlassGlassPlastic (CRPlastic (CR--39)39)Polycarbonate or Polycarbonate or TrivexTrivexHigh indexHigh index

1.661.661.711.71

Ophthalmic DispensingOphthalmic Dispensing


Frame AnatomyFrame AnatomyFrame frontFrame front

EyewireEyewireBridgeBridgeHingeHingeNosepadsNosepads

TemplesTemples


Frame size & measurementsFrame size & measurements

Boxing systemBoxing system““AA”” dimensiondimension““BB”” dimensiondimensionEffective diameterEffective diameterDistance between lensesDistance between lenses


Boxing SystemBoxing System

BB

AA

DBDBLL

EDED


Frame MaterialsFrame Materials

MetalMetalNickel compositeNickel compositeTitaniumTitaniumBendable MetalBendable MetalPrecious MetalsPrecious Metals

PlasticPlasticZylZylAcetateAcetate

Technology MaterialsTechnology MaterialsCarbon FiberCarbon FiberCeramicCeramic

Natural MaterialsNatural MaterialsWood Wood Horn / BoneHorn / BoneLeatherLeather

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Frame SelectionFrame Selection

Frame fit is most importantFrame fit is most importantFrame width equal face widthFrame width equal face widthLonger face, deeper the frame can beLonger face, deeper the frame can beBridge fit importantBridge fit important


Frame SelectionFrame Selection

Temples need to be Temples need to be long enough for a proper long enough for a proper bendbendCosmetic concernsCosmetic concernsCanCan’’t teach tastet teach taste

Cosmetic CriteriaCosmetic CriteriaBasicFacial Shapes

FittingShapes

Fitting Suggestions

Oval Normal May wear most any type

Oblong Long Face

Contrasting

Deep frameLow temple attachment

Round

SquareWide Face

ShapesNarrow frameHigh temple attachment

Base downtriangle

Erect (base-down triangular

faceContrasting

Fit to largest part of lowerfacial areaDark colors or bolderlooks

InvertedTriangle

Diamond

Inverted(base up)triangularface

Shapes Unobtrusive frame (metalor rimless)Light or medium weightframeLighter colorRound lens shapeDelicate characteristics offrame for women


Frame SelectionFrame SelectionLens SelectionLens SelectionOptions Options PupillaryPupillary distance measurementdistance measurementOC heightOC heightSeg heightSeg heightOrderingOrdering

Pupillary DistancePupillary Distance

PupilometerPupilometer

1 2 3 4 5 6 7

1st measurement 60 mm

1 2 3 4 5 6 7

2nd measurement 64 mm


Bifocal Bifocal SegSegHeightHeight

Trifocal Trifocal SegSegHeightHeight

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Jones Optical5209 South Penn

Oklahoma City, OK 73109

638-7889

Patient Jane Doe Date 2/23/01SPH CYL AXIS DEC PRISM PLASTIC GLASS

OD In Out

+1.00 - 0.25 90 1/2 Δ BU SV FDA TestedOS

+1.00 - 1.00 95 1/2 Δ BD RNDSeg Ht. Width Insert Total Pup Dist EXEC LENT

R R Dist Near

+2.00 20ST 28 TRIFOCAL

L L

ADD +2.00 20

28 66 62 OTHER

Set Lens Shape Edge Colour

F.P.D. A B ED LOC UNCUT Rimless Grove Drill Metal ZYL

Size BDG Temp Style ColorFRAMES

58 16 145 SafiloTitanium 109

GrayOT30

PINK

GREEN

GRAY

BROWN

OTHER:

GRADIENT TO

1

1

1

1

1

Lite

2

2

2

2

2

3

3

3

3

3

Clear

ACCT: REMARK SUPPLY TRAY#RX LENS $MISCTAXTOTALDATEINVOICE


Basic Frame AdjustmentsBasic Frame AdjustmentsFitting triangleFitting triangleFrame heightFrame heightVertex distanceVertex distanceFace formFace formPantoscopic anglePantoscopic angle

Retroscopic angleRetroscopic angle

Temple adjustmentTemple adjustment


Basic Adjustments:Basic Adjustments: Fitting TriangleFitting Triangle

Ophthalmic Dispensing: Ophthalmic Dispensing: PantoscopicPantoscopic AngleAngle

4 mm4 mm

Optical Optical centercenter

Optical Optical centercenter

CorrectCorrect

WrongWrong

Contact LensesContact Lenses


Soft contact lensesSoft contact lensesRigid contact lensesRigid contact lensesCare & handlingCare & handlingPatient educationPatient education

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Soft Contact LensesSoft Contact LensesRigid Contact LensesRigid Contact Lenses



ParametersParameters

Base curve radiusBase curve radiusLens powerLens powerOverall diameterOverall diameterOptical zone diameterOptical zone diameter

Peripheral curvesPeripheral curvesEdge & center thicknessEdge & center thicknessTintTintOrderingOrdering

Contact Lens DesignContact Lens DesignOverall Diameter (OAD)Overall Diameter (OAD)

Optical Zone OZOptical Zone OZ

Secondary Curve (SC)Secondary Curve (SC)

Peripheral Curve Peripheral Curve (PC)(PC)

Secondary Curve Secondary Curve Width (SCW)Width (SCW)

Peripheral Curve Peripheral Curve Width (PCW)Width (PCW)

Contact Lens DesignContact Lens Design

Peripheral Curve (PC)Peripheral Curve (PC)

Center Thickness (CT)Center Thickness (CT)

Base Curve (BC)Base Curve (BC)

Secondary Curve (SC)Secondary Curve (SC)

Optical Zone (OZ)Optical Zone (OZ)

Edge Edge ShapeShape

Overall Diameter Overall Diameter (OZ)(OZ)

TriTri--Curve Contact Lens DesignCurve Contact Lens Design

OAD = Overall DiameterOAD = Overall Diameter

OZ = Optical ZoneOZ = Optical ZonePCW = Peripheral Curve Width PCW = Peripheral Curve Width

SCW = Secondary Curve Width SCW = Secondary Curve Width

OADOADOZOZ

PCWPCW

PCWPCWSCWSCW

SCWSCWJUNCTIONJUNCTIONJUNCTIONJUNCTION

JUNCTIONJUNCTION

JUNCTIONJUNCTION

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OrderingOrderingCONTACT LENS ORDER FORM

Patient Name: John DoeSpecifications Ordered Specifications VerifiedDate 2/23/01 Date

O.D. O.S. O.D. O.S.B.C.R 7.89 7.81 B.C.RS.C.R./W 8.90 /.3 8.80 /.3 S.C.R./WI.C.R./W I.C.R./WP.C.R./W 110.9 /.3 10.8 /.3 P.C.R./WO.Z.D. 8.0 8.0 O.Z.D.Dia 9.2 9.2 DiaPower - 2.50 - 2.50 PowerC.T. .16 .16 C.T.Blend Med Med BlendTint Blue Blue TintDot O.D. Verified byAdditional Information

Accepted Rejected Returned for Credit Date ReturnedReason for return/reorder

Common Eye DisordersCommon Eye Disorders

BlepharitisBlepharitis BlepharitisBlepharitis

ConjunctivitisConjunctivitis Bacterial Bacterial ConjuntivitisConjuntivitis

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SubconjuntivalSubconjuntival HemorrhageHemorrhage PingueculaPinguecula

PtygeriumPtygerium HordeolumHordeolum (Sty)(Sty)

HordeolumHordeolum (Sty)(Sty) ChalazionChalazion

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ChalazionChalazion ChalazionChalazion

Eye with mature Eye with mature cataractcataract

CataractCataract CataractCataract

Anatomy of an Anatomy of an eye with a eye with a cataractcataract

Normal VisionNormal Vision Vision With A CataractVision With A Cataract

Blurred Vision Double Vision

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CataractCataract

Eye without cataractEye without cataract

Eye with cataractEye with cataract

CataractCataract

CataractCataract Ripe CataractRipe Cataract

Cataract SurgeryCataract Surgery

Opening the lensOpening the lens

Cataract Surgery continuedCataract Surgery continued

PhacoemulsificationPhacoemulsification

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Cataract Surgery continuedCataract Surgery continued

IOL in capsule bagIOL in capsule bag

Intraocular LensesIntraocular Lenses

Iris Fixated Posterior Chamber

GlaucomaGlaucoma KeratoconusKeratoconus

KeratoconusKeratoconus Macular DegenerationMacular Degeneration

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Effects Of Macular Effects Of Macular DegenerationDegeneration Diabetic RetinopathyDiabetic Retinopathy

Diabetic RetinopathyDiabetic Retinopathy Retinal DetachmentRetinal Detachment

FloatersFloaters

Refractive SurgeryRefractive Surgery

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Laser Vision CorrectionLaser Vision Correction

▪▪ PhotoablationPhotoablation occurs when specialized light is occurs when specialized light is used to remove tissue used to remove tissue

▪▪ This is the basis for all laser vision correcting This is the basis for all laser vision correcting proceduresprocedures


Broad Beam LasersBroad Beam Lasers

use a relatively large beam use a relatively large beam diameter (from 6.0 to 8.0 diameter (from 6.0 to 8.0 millimeters) to ablate the corneamillimeters) to ablate the cornea

has the shortest procedure time has the shortest procedure time of any laser of any laser

speed creates less likelihood of speed creates less likelihood of overcorrection and overcorrection and decentrationdecentration-- a complication caused by a complication caused by movement of the eye movement of the eye


Broad Beam LasersBroad Beam Lasers

disadvantage is an increased disadvantage is an increased possibility of center islands possibility of center islands -- a a complication related to ablationcomplication related to ablation

surgeons have learned to surgeons have learned to decrease the incidence of decrease the incidence of center islands by using several center islands by using several short laser pulses to ablate the short laser pulses to ablate the cornea instead of one longer cornea instead of one longer oneone

Refractive Surgery Refractive Surgery

Slit Scanning LasersSlit Scanning Lasers

use relatively small beams linked to a rotational device with use relatively small beams linked to a rotational device with slit holes that can enlargeslit holes that can enlarge

during surgery, the laser beam scans across these holes to during surgery, the laser beam scans across these holes to gradually increase the ablation zonegradually increase the ablation zone

uniform beam and potentially smoother ablations characterize uniform beam and potentially smoother ablations characterize slit scanning lasersslit scanning lasers

disadvantages disadvantages slightly higher risk for slightly higher risk for decentrationdecentrationslightly greater risk of overcorrectionslightly greater risk of overcorrection

Refractive Surgery Refractive Surgery

Spot Scanning LasersSpot Scanning Lasers

have the potential to have the potential to produce the smoothest produce the smoothest ablations ablations

use radar technology to use radar technology to track the eye's movement track the eye's movement to ensure proper to ensure proper centrationcentration

Can treat irregular Can treat irregular astigmatism and link to astigmatism and link to topographytopography


FLAP PROCEDURESFLAP PROCEDURESsurgeon cuts a flap in the cornea in order to access thesurgeon cuts a flap in the cornea in order to access theunderlying tissue underlying tissue

LASIK (LaserLASIK (Laser--Assisted InAssisted In--Situ Keratomileusis) Situ Keratomileusis) treats myopia, hyperopia, and astigmatismtreats myopia, hyperopia, and astigmatisma flap which includes tissue from the outer three corneal layersa flap which includes tissue from the outer three corneal layers is created with is created with a a microkeratomemicrokeratome, then an , then an excimerexcimer laser is used to remove laser is used to remove stromalstromal materialmaterial

LASEK (Laser Epithelial Keratomileusis)LASEK (Laser Epithelial Keratomileusis)cuts flap in the outer layer onlycuts flap in the outer layer onlyfor those with flat or thin corneasfor those with flat or thin corneas

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Refractive Surgery Refractive Surgery -- ProceduresProcedures

FLAP PROCEDURESFLAP PROCEDURES –– continuedcontinued

EpiEpi--LASEK LASEK surgeon does not use a blade, but uses an surgeon does not use a blade, but uses an epikeratomeepikeratome which which separates epithelial layers and creates an epithelial sheet separates epithelial layers and creates an epithelial sheet tissue below this is them removed with a lasertissue below this is them removed with a laser

ALK (Automated Lamellar ALK (Automated Lamellar KeratoplastyKeratoplasty) ) treats high levels of nearsightedness and mild farsightednesstreats high levels of nearsightedness and mild farsightednessin addition to a flap cut with a in addition to a flap cut with a microkeratomemicrokeratome, more corneal tissue is , more corneal tissue is removed with another pass of the blade to correct powerremoved with another pass of the blade to correct powernot as predictable as laser proceduresnot as predictable as laser procedures



OTHER PROCEDURES OTHER PROCEDURES

PRK (Photorefractive Keratectomy)PRK (Photorefractive Keratectomy)treats myopia, mild to moderate hyperopia, and astigmatismtreats myopia, mild to moderate hyperopia, and astigmatismuses an uses an excimerexcimer laser to remove tissue directly from the surface of the laser to remove tissue directly from the surface of the cornea, thus changing the shapecornea, thus changing the shapeinitially more discomfort than with a flap procedureinitially more discomfort than with a flap procedure

RK (Radial Keratotomy)RK (Radial Keratotomy)surgeon makes incisions in a radial spokesurgeon makes incisions in a radial spoke--like pattern to flatten the like pattern to flatten the corneacorneaNot as predictable as laser proceduresNot as predictable as laser procedures


OTHER PROCEDURESOTHER PROCEDURES

AK (Astigmatic Keratotomy) AK (Astigmatic Keratotomy) surgeon cuts certain areas that are too steep bulgy in order to surgeon cuts certain areas that are too steep bulgy in order to make them make them flatterflatterthis procedure can be used in addition to other types of surgerythis procedure can be used in addition to other types of surgery

HK (Hexagonal Keratotomy)HK (Hexagonal Keratotomy)used with hyperopic in the pastused with hyperopic in the past

discontinued due to high incidence of complicationsdiscontinued due to high incidence of complications



WavefrontWavefront sensingsensingan emerging diagnostic tool for measuring the refractive error an emerging diagnostic tool for measuring the refractive error of the eyeof the eyeconventional forms of refraction are limited to measuring the conventional forms of refraction are limited to measuring the best spherical and cylindrical refraction, but best spherical and cylindrical refraction, but wavefrontwavefrontsensing allows for measurements of other conditions within sensing allows for measurements of other conditions within the cornea that affect a patient's refractionthe cornea that affect a patient's refractionthese conditions are called higher order aberrationsthese conditions are called higher order aberrations



WavefrontWavefront sensingsensing

uses a simple technique where the patient stares ahead at a fieluses a simple technique where the patient stares ahead at a field and d and focuses on an object as a beam of light is projected into the eyfocuses on an object as a beam of light is projected into the eyeethis light is reflected off the back of the eye and back out, ththis light is reflected off the back of the eye and back out, then the en the machine maps where the exiting rays of light landmachine maps where the exiting rays of light landthis map is then used to determine what is going on in the eyethis map is then used to determine what is going on in the eyesome machines available today look at nearly 2,000 data points, some machines available today look at nearly 2,000 data points, providing providing a much more detailed map of the patient's eye.a much more detailed map of the patient's eye.

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WhatWhat’’s Next?s Next?

Testing to Earn CertificationTesting to Earn CertificationMost given in testing centersMost given in testing centers

See See www.aoa.orgwww.aoa.org for more detailsfor more detailsLive test usually only once each yearLive test usually only once each year

Generally at OptometryGenerally at Optometry’’s Meeting, this year in Orlandos Meeting, this year in Orlando

Once you PassOnce you PassLook for details about the CPOA testLook for details about the CPOA testBegin studying the SelfBegin studying the Self--Study Course for Paraoptometric Study Course for Paraoptometric CertificationCertification

Course EvaluationCourse Evaluation

Thank you!Thank you!Please take a few moments to completePlease take a few moments to complete

the course evaluation.the course evaluation.

QUESTIONS? QUESTIONS?

[email protected]@wacovision.comm

websitewebsitewww.wacovision.comwww.wacovision.com

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