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Insertion and removal of lenses requires handling them. Before
handling, keep the following in mind.
- Wash your hands thoroughly with soap. Avoid liquid soaps as
any residue on the hands may coat the lenses with detergent.
- Remove
all traces of soap, perfumes, hair sprays, creams and lotions.
- Use
your fingertips to handle the lens. Avoid contact with nails
as the nails may scratch the lenses. Keep your nails clean
and trimmed.
How are contact lenses inserted?
To insert contacts follow the steps given below
- Gently put you finger on the lens in the storage case. Let
the lens stick to your finger and then lift it out.
- Place the
lens on the tip of your forefinger.
- Pull the lower eye lid down
with the middle finger of the same hand you have the lens on.
- Hold
the upper lid firmly from above with the middle finger of the
other hand. The finger should be placed where the eyelid
meets the eyelashes.
- The eye is now wide open. Now gently place the lens on
the cornea.
- Release first the lower lid and then the upper lid
and blink. The lens is inserted.
Centering of lens
Sometimes a wrong procedure might displace the lens onto the
white part of the eye. The lens then has to be centered by any
of the two following ways
-
Close the eye and gently manipulate the lens onto the cornea
by using the eyelids.
- Keep your eye open and using your finger
on the edge of the lower
or upper eyelid gently manipulate the lens onto the cornea.
Problems may occur with disposable soft contacts if the surface
tension between the hand and the lens is too high. Then the lens
will turn inside out or fold in half. Irrigation in such cases
helps.
When are contact lenses normally removed?
Contacts are normally removed when:
- The wearer has to sleep or the lens has to be cleaned
- Evaluation
or treatment of the eye is needed
- Injury to the eye is to be
prevented due to prolonged contact lens wear
How are contact lenses normally removed?
The lower eyelid is pulled downwards with the middle finger while
the tip of the index finger is placed on the lower edge of the
lens. The lens is then slid down onto the sclera and compressed
slightly between the thumb and the index finger. This pinching
motion folds the lens and allows its removal from the eye.
What are the indications for removal other than sleep or cleaning?
Sometimes contact lenses must be removed in an emergency situation.
The indications for such removal are when:
-
The patient is in an altered sense of consciousness, unable
to express and also has reduced lid movement
- There is eye
trauma with the lens in place
- The person is unable to remove the
contact lens and needs assistance
How are contact lenses removed in an emergency?
Hard contact lens removal: In one procedure the patient leans
his face on a table or collecting cloth. The clinician then pulls
the lids in such a way that the lids lock against the edges of
the contact lens. The patient is then asked to look towards the
nose and then downwards towards the chin. This movement pushes
the lower lid under the lower edge of the lens and flips it off
the eye. Movement of the eye then flips the contact free. This
method requires a cooperative patient since the eyelids need to
be pulled tightly.
In less cooperative patients, a topical anesthesia is used in
a method where cotton tipped applicator is used. This applicator
is used to gently move the lens off the cornea and gently guide
it into the sclera. The applicator is then forced under the contact
to remove the lens. Care must be taken to avoid contact between
the lens and the applicator.
The easiest way to remove a lens is by using a wet suction device,
which simply lifts the lens off the eye. This method is used when
a perforated cornea makes lens removal difficult.
Soft contact lens removal: In this case the clinician pulls down
the lower eyelid with his middle finger while the tip of the index
finger is placed on the lower edge of the lens. The lens is then
slid down onto the sclera and compressed slightly between the
thumb and the index finger. This pinching motion folds the lens
and allows its removal from the eye.
What are the complications in lens removal?
Corneal abrasions are the common complications caused by improper
removal techniques. Sometimes it is difficult to make out whether
the injury is due to the patient or the clinician. Fortunately
most injuries are superficial and the cornea responds well to
treatment.
Conclusion
Insertion of contacts is easy. Removal is also usually easy.
In removal, difficult situations can arise during emergencies.
These could be patients with corneal injuries, patients who cannot
locate their lenses or patients with serious contact lens problems.
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