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Temporally displaced pupil

Awesome complex case referred by Dr. Wellish!

- 71 year old male referred for specialty contact lens evaluation.

- History of cataract surgery 20 years ago and the right eye went well, but the left eye suffered complications. There were some corneal and iris issues that took an incredibly long time to heal.

- He suffers from poor vision all around at distance and near with the left eye.

- He has a displaced miotic pupil temporally on the left eye.

- He does have some corneal irregularity in both eyes, according to topography.

- Best corrected vision was 20/50+ in the right eye and 20/80- in the left eye.

- I put a scleral lens trial on both eyes, just to see if he appreciated the improvement in vision in either eye. The plan was to show him the vision potential in each eye to see if it was worth it to pursue the fitting process.

- For the right eye, we fit him with an Ampleye/4800/ 16.50/8.04 BC and with an over-refraction, he could achieve 20/20 vision!

- For the left eye, we opted for the EyePrint Prosthetic and David from the lab helped me design the lens. The pupil is off axis about 1.36mm temporally and 5 degrees, so we are going to decenter the optics to center over his displaced pupil. With an over-refraction and eccentric viewing, he was able to see 20/25!

- He was thrilled and wanted to order lenses for both eyes.

- Ordered both lenses today, and we are super excited to see how he does at his dispense!

- Thank you @wellishvisioninstitute for trusting me with this very special patient!