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Summary OSCE Contact Lens related layman explanations

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I passed my OSCEs first time in 2024. These are my notes to help you get that pass. These are detailed and include hours of hard work.

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Optometry

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Contact lens complications


Acanthamoeba keratitis CLIPC/GPC




What is occurring?
After examining the front of the eyes, What is occurring?
I am seeing that the front surface called the After examining the front of the eyes, I
cornea which is like a clear window which am seeing some changes to the
allows light to enter so that we can see is underneath of the upper eyelid. The
inflamed by an infection and this is what we underneath of our eyelids are covered
potentially call as acanthamoeba keratitis. This by a clear-like film called the conjunctiva
causes the symptoms that you have come in that keeps our eyes lubricated. What I'm
today with such as the painful, red and light seeing today is that the conjunctiva is
sensitive eye as well as other signs such as inflamed and showing red bumps. This
inflammation. is what we call as giant papillary
conjunctivitis. This causes the
Why has it occurred? symptoms that you have come in today
This usually occurs in contact lenses wearers with such as irritation, blurry vision and
especially those who have had contact with sticky like discharge.
water (just like yourself) as water contains the
microscopic germ called acanthamoeba. Why has it occurred?
This condition usually happens in
Management (and reassurance) contact lens wearers like yourself and is
Acanthamoeba keratitis can often look like caused by deposits on lenses, an
other eye conditions and can therefore be quite allergic reaction to the chemicals used
difficult to diagnose and because it is potentially in cleaning the lenses or the lens edge
sight-threatening, I do need to refer you on an rubbing against the eyelids.
emergency basis today to the eye department Also, you are more likely to have it if you
and call them to let them know that you are on have any underlying allergic conditions
your way. Firstly, if you haven't already then I so more hypersensitive.
need you to cease lenswear. I would also like
you to take your lens and case to help them Management (and reassurance)
with the diagnosis. They will likely carry out a The good news is that this condition is
biopsy to find the cause of the inflammation not sight-threatening and easy to
and if they come to the same agreement as me manage. For the time being, I'm going to
then they will likely start you on antiseptic, advise you to cease lenswear for ~2
steroids, painkillers, and admit you into hospital weeks and to avoid rubbing the eyes as
to monitor you. that can make the inflammation worse. I
want you to use lubricating drops
Any further questions? 2-3x/day to stop any irritation. I want
Will I turn blind? you to use sodium cromoglicate drops

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