NCLE Advanced case studies
NCLE Advanced · Put your knowledge to work in context.
The NCLE Advanced is the advanced-level contact lens certification offered by the American Board of Opticianry & National Contact Lens Examiners (ABO-NCLE), the same organization that administers the ABO and NCLE basic exams. It is intended for contact lens professionals - opticians, fitters, and technicians - who already hold a foundational credential and want to demonstrate deeper competency in fitting, evaluating, and managing contact lens patients rather than entry-level knowledge. The NCLE Advanced case studies are 5 cases and about 4,064 words.
1Overnight Corneal Reshaping in a High Myope with With-the-Rule Astigmatism
A 15-year-old wants to stop wearing glasses for basketball and swimming. Manifest refraction is −5.50 −1.25 × 180 (spherical equivalent −6.13 D); keratometry is 43.00 @ 180 / 44.25 @ 090, corneal e-value 0.52, HVID 12.1 mm.
811 words, about 4 min2Midday Fogging and an Inferior Seal-Off in a Keratoconic Scleral Lens
A 44-year-old with keratoconus (Kmax 59.4 D, inferior-temporal apex, no hydrops, no graft) is fitted with a 16.5 mm corneal-scleral lens, base curve 7.40 mm, sagittal depth 4.60 mm, power −7.25 DS. At the 2-week visit he reports excellent vision and comfort on insertion, but by 3–4 hours vision clouds with a "smear" that clears on removal and reinsertion.
774 words, about 4 min3Painful Red Eye in a Extended-Wear Silicone Hydrogel Patient
A 28-year-old presents with two days of right eye pain rated 7/10, photophobia, and tearing. He wears monthly silicone hydrogel lenses (Dk/t ≈ 160) on an extended-wear schedule of 6–7 nights per week; the current pair is 2 months old.
778 words, about 4 min4First-Time Multifocal Wearer with Burning, Itching, and a Homemade Care Regimen
A 71-year-old retired music teacher is fitted with monthly replacement silicone hydrogel multifocals (Dk/t ≈ 100). Three weeks later she reports burning and stinging on insertion, redness by evening, a "greasy film" that forces her to remove the lenses early, and itchy bumps under the upper lids.
813 words, about 4 min5Prescription Release, an Expired Rx, and a Suspect Trial Lens
On a busy Monday: (1) a patient fitted 14 months ago calls demanding her contact lens prescription be faxed immediately to an online retailer; she has not been seen since the fitting and wants a two-year supply. (2) A fax arrives from a different internet seller asking you to "verify" a prescription for a lens your practice does not stock, with a two-day deadline.
888 words, about 4 min