1. CONTACT LENS DEPOSITS Group D PRESENTATION

2. Group D members ◦ Mohamed Saed Ali ◦ Mubarak Mawlid Yousuf ◦ Aidarous Ahmed Hersi ◦ Ridwan Awil Jama ◦ Maimoun Abib Hassan ◦ Naseem Hussein Hassan ◦ Najma Ibrahim Osman

3. topics ◦ What is contact lens deposition ◦ Types of contact lens deposition according to: ◦ position ◦ nature ◦ Effects of contact lens deposition ◦ Removers of contact lens deposition ◦ Procedure of removing contact lens deposition

4. Definition: ◦ CL deposits: any lens surface coating or matrix formation which is not flushed or rinsed from a lens by tears during blinking. ◦ TYPES ◦ According to position ◦ External deposits eye make up, air pollutants, patients finger ◦ Internal deposits ◦ Tear components—protein, lipid, mucin and.etc.

5. ◦ According to nature ◦ Organic deposits  protein  lipid ◦ In organic deposits ◦ Environmental deposits

6. ◦ How do deposits form on contact lens surface?  interaction between lens and content of tears  Evaporation of tears leaves residue on lens.  Deposits originate from tear film immediately start to form on the lens and these increase and vary over time.  Deposits also originate from external sources such as patients finger.

7. Organic deposits ◦ The organic deposits are the proteins,lipids,carbohydrates, pigments of organic origin, and deposits composed of micro-organisms with other substances. ◦ ◦ protein deposits ◦ Protein deposits on contact lens make them un-comfortable, irritating and itchy. ◦ They can make your vision blurry and may lead to conjunctivitis. ◦ There are two types of protein deposits on your tears. ◦ Native proteins are not visible and are easily removed when cleaning your lenses.

9. ◦ Denatured proteins that make the lenses hazy. ◦ If you are experiencing difficulties with your contact lenses, or you believe you may have any infection, discontinue wearing your lenses and contact your eye doctor. ◦ removing the protein ◦ Enzymatic cleaners can remove the protein from your lenses. ◦ After removing and cleaning your lenses, place them in the enzyme cleaner to soak for two hours. ◦ After two hours, clean and rinse them again.

10. ◦ Then place in disinfecting solution overnight. ◦ Its recommended that protein be removed once a week. ◦ You should use the lens products recommended by your eye doctor ◦ Enzymes can also remove other types of deposits if they are incorporated in the protein deposits.

11. How protein deposits get denatured. ◦ Environmental factors ◦ Heat ◦ Drying ◦ Oxidation ◦ UV-light

12. Procedure of removing… ◦ Enzymatic protein removers contain one of the following.  papain.  pancreatin  subtilisin A&B Papain Protease I,e enzyme that act as protein specifically. Derived from papaya plant.

13. ◦ Usually have slightly unpleasant odour due to the inclusion of cysteine. ◦ binds to contact lens material and can cause sensitivity reaction. ◦ Short 15 min soaking time possible. ◦ subtilisin A&B ◦ Proteases ◦ Subtilisin A formulated specifically for use in hydrogen peroxide lens care systems. ◦ Subtilisin B is formulated for use in conventional chemical and thermal systems.

14. Lipid deposits… ◦ symptoms Non-to mild discomfort, reduced vision. ◦ Signs ◦ Shimmering, oily film on the lens surface ◦ Etiology ◦ accumulation of lipid on soft lens surface. ◦ May be from poor tear film quality exacerbated by lid margin disease. ◦ Skin care products may deposit on lens during handling.

16. ◦ Prevalence ◦ Common ◦ DDX ◦ Separate from protein film by texture, uniformity and colour.

17. Lipid removing… ◦ Consider switching to DD lenses. DOLCE AND GABBANA ◦ Change lens material. ◦ Review rub and rinse routine. ◦ Switch to solution with surfactants.

18. In organic deposits.. ◦ The in organic deposits are calcium salts, phosphates and carbonates of calcium, ferrous oxide, salts and pigments derived from in organic chemicals. ◦ The most common types of in-organic deposits are “jelly bumps” which occurs most frequently on extended wear contact lenses. ◦ The jelly bumps are round, nodular deposits composed primarily of calcium, lipids and cholesterol. ◦ These deposits are difficult to remove from the contact lens.

19. Environmental deposits ◦ The most common environmental deposits are rust spots and particles from cosmetics. ◦ Rust spots are caused generally by the use of tap water or by foreign matter in the environment. ◦ They are generally orange and circular. ◦ Deposits from cosmetics have an iridescent. ◦ Greasy appearance and may be caused by ◦ mascara ◦ hair spray ◦ creams

21. Effects of deposits ◦ Deposits can cause dis-comfort and visual disturbances. ◦ They may also produce mechanical abrasions ◦ Also can cause immuno-allergic reactions and facilitate adherence of micro-organisms ◦ And subsequently cause infection ◦ The upper eye lid may be irritated by the deposit or grab onto it, causing the lens to decenter. ◦ Can cause corneal diseases if the patient is non-educated.

22. Deposit complication ◦ Reduced visual acuity ◦ Lens dryness proteins repel water and the lens may dry up more easily. ◦ Irritation and reduced comfort can cause shortened wear time. ◦ Causes allergic response. ◦ Micro-organisms attachment to deposits may cause eye infection.