Oh man this video just opened a big door in my brain! Thanks a lot for the content. You are helping so many people understand these concepts. Keep it up my friend.
Hey man, I just left the testing facility. I just passed my ncle. I wanted to thank you. Your videos certainly help me understand difficult Concepts. You the goat 🐐
Just wanted to let you know that I just finished taking my NCLE a few minutes ago and I passed!! Thank you for making these videos that help explain things way better than books can. I have a hard time learning but your videos make it seem like I am in your class. Thanks again!!
I’ve been watching all your videos throughout my studying process for my NCLE. I’ll be taking it soon. Thank you for your help, it means a lot to have someone to be able to explain it in ways you sometimes can’t think of yourself!!
Hola Sam, I want to say THANK YOU SO MUCH, for your videos. I was studying for my NCLE test for 3 months along side watching your video. Super easy to understand even for me 😊 (no much English) I passed my test one week ago. So, thank you, thank you, thank you.
You are incredibly helpful with your content. I am preparing for the national board of optometry exams and have been missing so many gaps in my knowledge that you are filling and I was always frustrated in class. A GODSEND!!
This came at a perfect time! Taking ncle Saturday and this is the only thing I’m unsure on. I understand the theory behind each, but was unsure on the dioptric limits for each type. Thanks!
Hi, question. On the back toric lens example, did you compensate for vertex distance on the rx at the 90th meridian because the corneal astig is steeper at the 90th meridian?
I can definitely put up a soft lens video. The reason that I have not had much content on soft lenses is mainly due to their ease of fitting. I try and tackle the topics that are most often troublesome. Perhaps a video “when you should for soft lenses” or “when you should not fit soft lenses” would be a great addition. Thanks for watching!
@@nclecontactlenstraining I’m taken my ncle in February and I need help on those follow ups.. thank you so much for all your help your videos are Great !
Hi, Lysbeth. That is correct. If the lens is +/- 4 diopters in either major meridian we need to compensate. That being said you more than likely will only see the minus cyl variation on the NCLE 😃
Are there any rules for fitting rgp lenses for oblique astigmatism? Many of the examples I see are WTR OR ATR astigmatism. What if it’s oblique? Do you follow the same rules?
Great question, Michelle! WTR astigmatism is more “forgiving” than ATR or oblique. This is because the lens will tend to move in the direction that the cornea is the steepest (so a WTR cornea will have the lens drift up and down versus side to side). As you can imagine, a lens moving up and down is more comfortable and visually acceptable than side-to-side. So prettymuch, treat oblique astigmatism as you would ATR for most examples. Hope that helps 😱 😬
Without reviewing the video, which I highly dislike listening to myself speak 😂, the above example shows all of the cylinder on the cornea (Ks match refracted cyl). If the lens was fit “on k” the power would be -1.00 sph as there is no need to compensate VD and the GP lens can handle the astigmatism. Thanks for watching! 😊
Good Morning. I have my advanced coming up , and these I struggle with the most due to knowing what is best fit for the patient. For the first problem you did since we have 2D of corneal and 2D of lenticular would that not be considered Bitoric? Or is it to where we Multiplied 2.00D of corneal astigmatism by 1.5 which gave you 3D of WTR , which made it be possible for a spherical RGP? The toughest thing is , is that you can fit many contacts to one RX , it's just identifying the best fit for it....
Hey Tiffany! First off - Congrats for deciding to take the NCLE advanced exam! You are very correct in that many questions have multiple possible answers. It is all about choosing the BEST option. If you stick to the general rules of thumb you can navigate through some of the more difficult fitting questions. Could we use a bitoric? Sure we could. Could we use a front toric? You bet we can! For the NCLE L-ADV you really need to just logically think through the questions using all of your gained contact lens knowledge.
@@nclecontactlenstraining Thank you , I am hoping I'll past first try but so much to study in very little time. That's the most tricky part for me , I'll be studying the rules , only thing is the rules mentioned here versus my test review book 2 is slightly different for example when we are referring to FST you had mentioned LESS than 1.00D of corneal cyl and my book is saying less than 2.50D of corneal Cyl, so it is just making sure I am studying the right knowledge , and the other thing that is stumping me is the 1/3 2/3rd rule when its coming to BST... I am not understanding that one quite well. I am of course watching your videos they helped a lot for my past exams . Is there any tips or anything else specific you'd recommend me to study for the advanced what I should look out for , for us on the most ? Thank you so very kindly for such a rapid response. -Tiffany H.
@@tiffanyherscu6191 I’m not going to lie I absolutely DESPISED the NCLE-AC when I took it. NONE of the advanced material that I labored over was actually on it. The test is designed so that you literally have to understand how contact lenses work to be able to reason through the answers and select the appropriate one. If I were to start studying for the test again today I would brush up on all Of the basics of contact lenses and have a strong foundation to make educated guesses from. Send me an email and I will be glad to offer you another resource that may benefit you. swinnegrad@universityeye.com You’ve got this 💪🏼
@@nclecontactlenstraining For the Back Surface Toric we know we want more toricity in the back than the front. There is a question that states : The best parameters for a BST would be ? The RX is -1.00-3.00x180 and K's are 41.25 @180 and 43.25 @090 So we have -3.00D of Lenticular and for our K's we have 2.00D of corneal if I multiply my corneal by 1.5D it will give me 3.00D which relatively be Biotic no?? I don't understand the concept quite well where it says a "spherical" front surface when we still have about 2.00D of Lenticular. After applying the 1.5 Rule and it giving me a total of 3.00D that means I have 1.00 D remaining which will be applied to the BACK to make it a BST to compensate the remainder of 1.00D? I am so sorry for all these questions I am bombarding you with , just need to understand the concept which can be quite confusing to grasp.
@@tiffanyherscu6191 This is an excerpt from an article I wrote. I hope it helps with this topic! If there is greater than 3D of corneal cylinder and the corneal and refracted cylinder do not equal each other use a bitoric lens. Think bitoric when you see an unusually high level of astigmatism and the measurements do not reflect the below statement... Back toric lenses are never ideal because they will induce astigmatism. Use back toric lenses when the refractive cylinder is around 50 percent greater than the corneal toricity. On the test when you see this ratio they probably want a back toric lens... Ex. Ks 42.00/44.00 x 180 Rx -1.00 -3.00 x 090
Ok, so I’m getting confused when you use the “dropping glasses down nose” and saying the lens acts more plus the further it moves from the eye. I understand a -4.00sph glx is a -3.75 clx on the eye, so that would be more plus coming closer to eye and a +10 glx is a + 11 clx, as you pointed out in previous videos. Is this example misspoken or am I not understanding something? Thank you and I’ve been using your whole series to study for my ncle in two days and I really appreciate the information you’ve been putting out.
Hey! Thanks so much for watching. Remember that ANY LENS WILL ACT MORE PLUS (less minus) the farther away that it gets from the eye. A -4.00 glasses lens would be a -3.75 in contacts. (-3.75 is less minus than a -4.00, you can also think of this as “more plus”) A +10.00 in glasses would be a +11.00 in contacts because it becomes more plus/less minus. Think of it like this - you want the contact lens to mimic the behavior of the glasses, so the contact needs to be a stronger power because it’s on the eye to yield the same visual effect as the glasses Rx which is farther from the eye. Hope this makes sense - let us know when you crush the test 💪🏼
@@nclecontactlenstraining I passed my test today, and it was mainly your videos that did it, with some personal experience as well. The test questions are different, a lot having to do with symptoms and what about the contact is causing it, different cleaning solutions, so I think more videos are needed to address some of these, but overall, the content in your videos helped my pass. Thank you.
I just passed my NCLE today! Thanks to your videos! I need to take both my practical exams, how much time should I give myself to study for those, I want to take asap. Also, besides the abo-ncle website, is there any other material out there to help study for practicals? Thank you!!!
Congrats on passing! The best review for the practicals is definitely the simulations on the website. Just get online and review those for 20 minutes a night for a few weeks and you should be good. Way to go 💪
Your videos are great. I have a question. For these Spherical RGP, does it mean a +2.00DS RGP will correct a corneal astigmatism? Or will it be Plano RGP will correct any corneal astigmatism of about +2.00DS? I want to know, if I want to order the spherical RGP, what the power would be. Plano or +2.00DSm Thank you
Hey! Thanks for watching. Typically, once the Rx is in minus cylinder form you can start with the sphere power for the first RGP trial lens. For example: -2.00 -1.00 x 090 You could prescribe a -2.00 sphere Then do an over refraction on the patient (refract them with the contact lens in situ) to see if you need to adjust the strength. If you fit flatter than K or steeper than K you will need to follow the SAM and FAP rules covered in other videos. Hope this helps! Sam
Hi Sam, I find your videos very helpful. I'm re-taking the NCLE exam September 30th. I need help in these areas: Refractive Errors, Diagnostic Fitting, Dispensing, Follow-Up. Any suggestions? Appreciate any help.
Glad you are finding the videos helpful! My best advice would be to pair the videos up with a great question, answer and explanation book. Hit those practice questions hard 🥊
Hey! My videos aren’t geared towards the practical simulations, HOWEVER; the information in them will definitely prepare you for the NCLEP multiple choice questions and help you reason through some of the practical elements. Thanks for watching 😊📺
Oh man this video just opened a big door in my brain! Thanks a lot for the content. You are helping so many people understand these concepts. Keep it up my friend.
Thanks for the kind words. Makes me want to produce more content!
Hey man, I just left the testing facility. I just passed my ncle. I wanted to thank you. Your videos certainly help me understand difficult Concepts. You the goat 🐐
Congrats! I know that is a great feeling to pass that test! 💪
Just wanted to let you know that I just finished taking my NCLE a few minutes ago and I passed!! Thank you for making these videos that help explain things way better than books can. I have a hard time learning but your videos make it seem like I am in your class. Thanks again!!
Way to go! I really appreciate you sharing your feedback. CONGRATS!
@@nclecontactlenstraining Thank you!!
I'm was having trouble understanding "how to" determine the proper lens. I had to watch this a few times 😊 Thank you Sam.
Glad the video was helpful!
I’ve been watching all your videos throughout my studying process for my NCLE. I’ll be taking it soon. Thank you for your help, it means a lot to have someone to be able to explain it in ways you sometimes can’t think of yourself!!
Thanks for watching, Holden. CRUSH IT 💪
taking my ncle next month- watching ur videos r getting me thru all the math I blocked out in high school ty! so much!
Haha very good 😊
You are CL Jesus 🙌 this has helped so Immensely I've been looking for a study resource like this for a long time I cannot thank you enough
Hi, Luke! I’m so glad the videos are helpful for you. I’d appreciate you sharing the channel to extend its reach. You’ve got this 💪
Is there a reason why you transposed the back toric example and not the front surface toric example?
Hola Sam, I want to say THANK YOU SO MUCH, for your videos. I was studying for my NCLE test for 3 months along side watching your video. Super easy to understand even for me 😊 (no much English) I passed my test one week ago. So, thank you, thank you, thank you.
Love this feedback! Thank you SO MUCH for sharing. Congrats!!! 😊
You are incredibly helpful with your content. I am preparing for the national board of optometry exams and have been missing so many gaps in my knowledge that you are filling and I was always frustrated in class. A GODSEND!!
Reading this comment makes me so happy 😊 Thank you for watching!
Thank you for sharing your knowledge with us. The GOAT
@@SG-qh4jz 😊 thanks
I take the NCLE tomorrow! I NEEDED this! Thank you!
Thanks for watching 📺 Good luck 👍🏼
Thanks for this video! I love how you explain and give ideas on how to remember the theories.
Hi, Isabel. I really appreciate you watching! 🙂
you are super good and impactful. Kudos.
Thank you friend!
This came at a perfect time! Taking ncle Saturday and this is the only thing I’m unsure on. I understand the theory behind each, but was unsure on the dioptric limits for each type. Thanks!
Hey, Jordan! Thanks for watching/subscribing... You’ve got this 💪
@@nclecontactlenstraining I passed! Thanks again!
@@jordancausey1812 Heck yes!!! Congrats 😊
Hi, question. On the back toric lens example, did you compensate for vertex distance on the rx at the 90th meridian because the corneal astig is steeper at the 90th meridian?
I noticed there are no videos on when to use soft Toric lens, i reviewed the one covering soft spherical.Maybe add this in the future please.
I can definitely put up a soft lens video. The reason that I have not had much content on soft lenses is mainly due to their ease of fitting. I try and tackle the topics that are most often troublesome.
Perhaps a video “when you should for soft lenses” or “when you should not fit soft lenses” would be a great addition. Thanks for watching!
Great information, I am glad I found these videos! Taking my NCLE June 7th.
Glad you found these videos, too! Sure hope they help 😊
Eeekk..taking mine June 14th! Good luck to you
Just 12 more days ‘til you are NCLE certified! 🙌
@@yvettegarcia527 ahhh how exciting!! Good luck! I’m a ball of nerves right now going over all of this content over and over again.
@@mariahrivera7135 did you pass??
Thanks for this breakdown, its extremely useful
Thank you for sharing your knowledge simple way
I appreciate you watching! 😊
Thank you for the videos I’ll be taking my NCLE soon. And these videos really help.
Hi, Paulina! Thank you for your support. I am very glad that you find these videos helpful to supplement your studies 📚
Can you do videos on follow up appointments after the fitting done pleaseee.
Hi, Johanna.
I will be added more videos soon and I know that I need to add one on follow-up care. Stay tuned 📺
Thanks for watching 😊
@@nclecontactlenstraining I’m taken my ncle in February and I need help on those follow ups.. thank you so much for all your help your videos are Great !
Thank you for you videos!! They are helpful!!
I really appreciate you watching. Thank you!!!
Yikes !! We vertex the cylinder? So whether it’s the sphere or cylinder above 4 diopters we vertex ? Correct?
Hi, Lysbeth.
That is correct. If the lens is +/- 4 diopters in either major meridian we need to compensate.
That being said you more than likely will only see the minus cyl variation on the NCLE 😃
I was surprised also, thank you for asking this question, answer is very helpful!👌
@@nclecontactlenstraining thank you, I've never heard about vertexing the Cylinder!👌
Hey Sam! Can you please do an example of when given a lens power and then given an overrefraction and how to calculate it. Thanks!
Hi, Aide! Sounds like a great video topic to explore. Most definitely!
ua-cam.com/video/iIduVc9HNEs/v-deo.html
Any good tips for the practical test? What exactly besides the simulations is needed for that test? Last one
Are there any rules for fitting rgp lenses for oblique astigmatism? Many of the examples I see are WTR OR ATR astigmatism. What if it’s oblique? Do you follow the same rules?
Great question, Michelle!
WTR astigmatism is more “forgiving” than ATR or oblique.
This is because the lens will tend to move in the direction that the cornea is the steepest (so a WTR cornea will have the lens drift up and down versus side to side). As you can imagine, a lens moving up and down is more comfortable and visually acceptable than side-to-side.
So prettymuch, treat oblique astigmatism as you would ATR for most examples.
Hope that helps 😱 😬
Thank you! This helps!
Hi Sam. The first sample you gave for the spherical rgp lens, -1.00-2.00x180
42/44.
What would b the final power given on the rgp?lens?
Without reviewing the video, which I highly dislike listening to myself speak 😂, the above example shows all of the cylinder on the cornea (Ks match refracted cyl). If the lens was fit “on k” the power would be -1.00 sph as there is no need to compensate VD and the GP lens can handle the astigmatism.
Thanks for watching! 😊
Amanzing as always!😍🙌🏼thank you!
Test on friday!!
How exciting! You’ve got this 💪 👁
Good Morning. I have my advanced coming up , and these I struggle with the most due to knowing what is best fit for the patient. For the first problem you did since we have 2D of corneal and 2D of lenticular would that not be considered Bitoric?
Or is it to where we Multiplied 2.00D of corneal astigmatism by 1.5 which gave you 3D of WTR , which made it be possible for a spherical RGP?
The toughest thing is , is that you can fit many contacts to one RX , it's just identifying the best fit for it....
Hey Tiffany!
First off - Congrats for deciding to take the NCLE advanced exam! You are very correct in that many questions have multiple possible answers. It is all about choosing the BEST option.
If you stick to the general rules of thumb you can navigate through some of the more difficult fitting questions.
Could we use a bitoric? Sure we could.
Could we use a front toric? You bet we can!
For the NCLE L-ADV you really need to just logically think through the questions using all of your gained contact lens knowledge.
@@nclecontactlenstraining Thank you , I am hoping I'll past first try but so much to study in very little time.
That's the most tricky part for me , I'll be studying the rules , only thing is the rules mentioned here versus my test review book 2 is slightly different for example when we are referring to FST you had mentioned LESS than 1.00D of corneal cyl and my book is saying less than 2.50D of corneal Cyl, so it is just making sure I am studying the right knowledge , and the other thing that is stumping me is the 1/3 2/3rd rule when its coming to BST... I am not understanding that one quite well. I am of course watching your videos they helped a lot for my past exams .
Is there any tips or anything else specific you'd recommend me to study for the advanced what I should look out for , for us on the most ?
Thank you so very kindly for such a rapid response.
-Tiffany H.
@@tiffanyherscu6191 I’m not going to lie I absolutely DESPISED the NCLE-AC when I took it. NONE of the advanced material that I labored over was actually on it. The test is designed so that you literally have to understand how contact lenses work to be able to reason through the answers and select the appropriate one. If I were to start studying for the test again today I would brush up on all
Of the basics of contact lenses and have a strong foundation to make educated guesses from.
Send me an email and I will be glad to offer you another resource that may benefit you.
swinnegrad@universityeye.com
You’ve got this 💪🏼
@@nclecontactlenstraining For the Back Surface Toric we know we want more toricity in the back than the front.
There is a question that states :
The best parameters for a BST would be ?
The RX is -1.00-3.00x180
and K's are 41.25 @180 and 43.25 @090
So we have -3.00D of Lenticular
and for our K's we have 2.00D of corneal if I multiply my corneal by 1.5D it will give me 3.00D which relatively be Biotic no??
I don't understand the concept quite well where it says a "spherical" front surface when we still have about 2.00D of Lenticular. After applying the 1.5 Rule and it giving me a total of 3.00D that means I have 1.00 D remaining which will be applied to the BACK to make it a BST to compensate the remainder of 1.00D?
I am so sorry for all these questions I am bombarding you with , just need to understand the concept which can be quite confusing to grasp.
@@tiffanyherscu6191
This is an excerpt from an article I wrote. I hope it helps with this topic!
If there is greater than 3D of corneal cylinder and the corneal and refracted cylinder do not equal each other use a bitoric lens. Think bitoric when you see an unusually high level of astigmatism and the measurements do not reflect the below statement...
Back toric lenses are never ideal because they will induce astigmatism. Use back toric lenses when the refractive cylinder is around 50 percent greater than the corneal toricity. On the test when you see this ratio they probably want a back toric lens...
Ex. Ks 42.00/44.00 x 180
Rx -1.00 -3.00 x 090
Ok, so I’m getting confused when you use the “dropping glasses down nose” and saying the lens acts more plus the further it moves from the eye. I understand a -4.00sph glx is a -3.75 clx on the eye, so that would be more plus coming closer to eye and a +10 glx is a + 11 clx, as you pointed out in previous videos. Is this example misspoken or am I not understanding something? Thank you and I’ve been using your whole series to study for my ncle in two days and I really appreciate the information you’ve been putting out.
Hey! Thanks so much for watching.
Remember that ANY LENS WILL ACT MORE PLUS (less minus) the farther away that it gets from the eye.
A -4.00 glasses lens would be a -3.75 in contacts. (-3.75 is less minus than a -4.00, you can also think of this as “more plus”)
A +10.00 in glasses would be a +11.00 in contacts because it becomes more plus/less minus.
Think of it like this - you want the contact lens to mimic the behavior of the glasses, so the contact needs to be a stronger power because it’s on the eye to yield the same visual effect as the glasses Rx which is farther from the eye.
Hope this makes sense - let us know when you crush the test 💪🏼
@@nclecontactlenstraining I passed my test today, and it was mainly your videos that did it, with some personal experience as well. The test questions are different, a lot having to do with symptoms and what about the contact is causing it, different cleaning solutions, so I think more videos are needed to address some of these, but overall, the content in your videos helped my pass. Thank you.
@@tmi9885 love hearing this! CONGRATS! Time to celebrate 🍾🎊🎉
I just passed my NCLE today! Thanks to your videos! I need to take both my practical exams, how much time should I give myself to study for those, I want to take asap. Also, besides the abo-ncle website, is there any other material out there to help study for practicals? Thank you!!!
Congrats on passing! The best review for the practicals is definitely the simulations on the website. Just get online and review those for 20 minutes a night for a few weeks and you should be good.
Way to go 💪
Your videos are great. I have a question.
For these Spherical RGP, does it mean a +2.00DS RGP will correct a corneal astigmatism? Or will it be Plano RGP will correct any corneal astigmatism of about +2.00DS?
I want to know, if I want to order the spherical RGP, what the power would be. Plano or +2.00DSm
Thank you
Hey! Thanks for watching.
Typically, once the Rx is in minus cylinder form you can start with the sphere power for the first RGP trial lens. For example:
-2.00 -1.00 x 090
You could prescribe a -2.00 sphere
Then do an over refraction on the patient (refract them with the contact lens in situ) to see if you need to adjust the strength.
If you fit flatter than K or steeper than K you will need to follow the SAM and FAP rules covered in other videos.
Hope this helps!
Sam
@@nclecontactlenstraining Great. Thank you
I love your video
You da man, Eric! Thanks for watching 📺
Hi Sam, I find your videos very helpful. I'm re-taking the NCLE exam September 30th. I need help in these areas: Refractive Errors, Diagnostic Fitting, Dispensing, Follow-Up. Any suggestions? Appreciate any help.
Glad you are finding the videos helpful! My best advice would be to pair the videos up with a great question, answer and explanation book. Hit those practice questions hard 🥊
@@nclecontactlenstraining thank you!
Nathn... I trust you passed. I failed my 1st round. Ironic I needed to study in the same areas. I'm going back soon for round #2 😊
You’ve got this 💪🏼
Will this be on the practical too?
Hey! My videos aren’t geared towards the practical simulations, HOWEVER; the information in them will definitely prepare you for the NCLEP multiple choice questions and help you reason through some of the practical elements.
Thanks for watching 😊📺
how did you get 8.12 at 90?
He mentions you have to compensate for vertex distance, and he has videos that go into that further.
Thank you so much!
Thank you for watching, Maria!
THANK YOU !!!
You’re welcome!
legend
Tor baba ki korto landan o Caros lamp