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About the NCLE

The National Contact Lens Examiners (NCLE) certification is a pivotal credential in the field of optometry, specifically for those specializing in contact lens fitting and care. This certification plays an essential role in the optical industry by ensuring that contact lens technicians, opticians, and other eye care professionals possess a comprehensive understanding and proficiency in the science and practice of contact lens fitting.

Contact lenses are medical devices that require precise fitting and careful management to ensure eye health and optimal vision. The NCLE certification is designed to validate the expertise of professionals in this specialized area. It covers a broad range of topics, including the anatomy and physiology of the eye as it relates to contact lens wear, the principles of contact lens fitting, contact lens design and materials, and the management of contact lens complications.

To achieve NCLE certification, candidates must pass a rigorous examination that tests their knowledge and skills in these areas. The exam is comprehensive, covering theoretical knowledge (see outline below) as well as practical aspects of contact lens fitting and patient care. This includes understanding the indications and contraindications for contact lens wear, mastering the techniques for contact lens fitting and evaluation, and being able to provide appropriate patient education and follow-up care.

The certification process underscores the importance of not only technical skills but also a commitment to ongoing professional development. Given the rapid advancements in contact lens technology and materials, NCLE-certified professionals are required to engage in continuing education to maintain their certification. This ensures that they remain current with the latest developments and best practices in contact lens fitting and care.

In the optical industry, the NCLE certification is recognized as a benchmark in the field of contact lens practice. It provides assurance to patients, employers, and colleagues that a professional has demonstrated a minimum level of knowledge and competence in this specialized area. For practitioners, the certification can enhance professional credibility and career opportunities, often leading to greater trust from patients and potentially more advanced professional roles.

Moreover, in some regions, the NCLE certification is a requirement or highly valued for licensure or professional practice. This highlights the certification's significance not only in setting professional standards but also in influencing regulatory standards within the field of optometry, particularly in the area of contact lens fitting and care.

 

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

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