OpenOptix NCLE Study Guide

Welcome to the project page for the OpenOptix NCLE Certification Study Guide. The Open NCLE Study Guide is the product of the OpenOptix initiative, a communty effort designed to produce free and open optical knowledge content and improve optical care worldwide.

Complete the form below to have OpenOptix updates sent via email regarding new and current OpenOptix projects. You will not receive any email from this list other than OpenOptix updates and may unsubscribe at any time.



Download the latest working version of the OpenOptix NCLE Study Guide v0.2.

If you would like to participate or contribute to the project please, logon to the Open ABO Study Project forum or contact Keith Benjamin.

OpenOptix NCLE Certification Study Guide Outline

Section 1

Anatomy and Physiology

1. Outer structures of the Eye
   1. Lashes
   2. Lids
   3. Conjunctiva
   4. Tear film
   5. Glands
   6. Muscles
   7. Orbit
2. Globe
   1. Outer tunic
   2. Middle tunic
   3. Inner tunic
   4. Crystalline lens
   5. Chambers

Section 2

Overview of Contact Lens Development

1. Earliest contact lens theories and designs
2. Scleral contacts
3. First corneal contacts
4. Development of RGPs
5. Earliest soft contact lenses
6. Introduction of disposables
7. Silicone Hydrogels developed
8. Basic manufacturing procedures

Section 3

Basic Contact Lens Terminology

1. Refractive Errors
   1. Emmetropia
   2. Hyperopia
   3. Myopia
   4. Different types of astigmatism
2. Contact Curves
   1. Base curves
   2. Optical zone
   3. Intermediate curves
   4. Peripheral curves
   5. Blend curve
   6. Anterior curve
3. Diameter
4. Center thickness
5. Lens power
6. Lens edge designs
   1. Anterior zone
   2. Posterior zone
   3. Edge apex
   4. Lenticular flange
   5. Prism ballast
   6. Periballast
   7. Truncation
7. Basic contact lens designs
   1. Spherical
   2. Front toric
   3. Back toric
   4. Bitoric
8. Keratometry  readings

Section 4

Patient Selection

1. Optical considerations to pick contacts over glasses
   1. Keratoconus
   2. Irregular astigmatism
   3. Fields of vision
   4. Magnification/minification
   5. Anisometropia
   6. Aberrations
2. Ocular Health Needed to Wear Contacts
   1. Lids
   2. Tear film
   3. Conjunctiva
   4. Cornea
3. Contraindications for Contact Lens Wear
   1. Systemic Diseases
   2. Medications
4. Initial Evaluations
   1. Occupations
   2. Hobbies/sports
   3. Patient motivation
   4. Ability to follow recommendations for care

Section 5

The Slit Lamp (Biomicroscopy)

1. Design
2. What it is used for
   1. Eye health
   2. Contact lens fitting
   3. Detecting contact lens defects
3. Slit lamp illumination types and when to use them
   1. Direct
   2. Diffuse
   3. Indirect
   4. Retro
   5. Sclerotic scatter
4. Filters and their purpose
   1. Blue colbalt
   2. Wratten #12 yellow
   3. Green
5. Fluorescein Patterns
   1. Ideal
   2. Steep
   3. Flat
   4. With the rule
   5. Against the rule
6. Staining
   1. Stippling
   2. Punctuate
   3. Arcuate
   4. Abrasion
   5. Foreign body
   6. Dimple veil
   7. 3-9 o’clock

Section 6

Keratometry

1. History and Design
2. How it is used for
   1. Measuring convex surfaces
   2. Measuring concave surfaces
3. How to use
   1. Focusing the eyepiece
   2. Extending the range
   3. Attaching the topogometer
4. Measuring the central cornea
5. Measuring the peripheral cornea
6. Interpreting the K readings
7. Common errors
8. New topographical mapping software

Section 7

Soft Contact Lens Fitting

1. Candidates
   1. Children
   2. Athletes
   3. RGP failures
   4. Occasional wearers
2. Contraindications
   1. Environment
   2. GPC
   3. Irregular astigmatism
   4. Conjunctival irregularities
3. Wearjng Schedules
   1. What is the patient looking for
   2. What is feasible
   3. The different types
4. Materials
   1. Group I ~ low water, non-ionic
   2. Group II ~ high water, non-ionic
   3. Group III ~ low water, ionic
   4. Group IV ~ high water, ionic
   5. Oxygen permeability
5. Parameters
   1. Base curve
   2. Diameter
   3. Power
   4. Tints
   5. Thickness
   6. Edge design
6. Fit Evaluation
   1. Corneal coverage
   2. Movement
   3. 3 point touch
   4. Visual acuity
   5. Comfort
7. Lens ordering and verification
8. Delivery Procedures
9. Follow up visits
10. Problem solving

Section 8

Extended Wear Contact Fitting

1. Definition of extended wear
   1. Benefits
   2. Most common risks
2. Candidates
   1. Previous wearing history
   2. Occupations
   3. Contact sports
   4. Medical history
3. Fitting procedures
   1. Much the same as soft or rigid contact fitting
   2. Special attention to slit lamp
   3. Watch for corneal swelling
4. Materials
   1. High Dk
   2. Deposit resistant
   3. Water content
   4. Silicone hydrogels
   5. RGP – Fluoro-silicone acrylates
5. Lens Delivery and Care procedures
6. Common Complications
   1. Edema
   2. Solution reaction
   3. Corneal changes
   4. GPC
   5. Blurry vision
7. Follow up appointments

Section 9

Rigid Gas Perm Contact Fitting

1. Patient selection
2. Spectacle RX conversion
3. K readings
4. Apical Clearance
5. Corneal Alignment
6. SAM/FAP
7. Over-refraction
   1. Diagnostic lenses
   2. Residual astigmatism

Section 10

Contact Lens Verification and In-office Modification

Section 11

Contact Lens Dispensing and Care Procedures

1. Soft contact
   1. Insertion
   2. Removal
   3. Cleaning
   4. Wearing schedule
   5. Adaptation
   6. Emergencies and complications
2. RGP
   1. Insertion
   2. Removal
   3. Cleaning
   4. Wearing schedule
   5. Adaptation
   6. Emergencies and complications
3. Cleaning Solutions
4. Wetting Solutions
5. Salines
6. Rewetting Drops
7. Disinfection Systems
8. Preservatives and Disinfectants
9. Written Instructions

Section 12

Contact Lens Follow Up Procedures (SOAP)

1. Subjective Examination
2. Objective Examination
3. Assessment
4. Plan

Related content:

1. The Free OpenOptix ABO Study Guide: Update
2. OpenOptix ABO Study Guide
3. The Free OpenOptix ABO Study Guide
4. OpenOptix
5. OpenOptix Works!