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Contact lenses for high astigmatism

We saw our Latitude scleral lens patient today for his dispense and insertion/removal training.

He is a 35 year old white male and he has regular astigmatism, but a large amount (over 5 diopters in the left eye). He's tried many different contact lenses in the past, but he complains that they don't seem to fit correctly and the vision also seems sub-optimal. Patients with large amounts of astigmatism often see better with more custom lenses, due to the fact that standard soft contact lenses have limited parameters and availability. Most standard soft contact lenses can go up to 2.75 diopters of astigmatism. If you have more than this, the options become more limited. I always recommend more custom contact lenses for patients with higher amounts of cylinder.

After reviewing the images of his eye together and explaining pros and cons of different lens types, we decided to try the Latitude custom scleral lens. The reason we selected this option is because it is very stable on the eye, so the the optics are likely to be superior to his soft contact lenses. When you have a large amount of astigmatism, it is very important that contact lens centers on the eye and remains stable. If there is any sort of rotation of the contact lens, the vision could be affected. This is why patients with large amounts of astigmatism usually see better with a more custom lens, such as a scleral lens.

The lenses fit very well on both eyes and he can see 20/20 in the right eye and 20/30 in the left eye. He did take a small over refraction on each eye, which improved his vision to 20/20 in the left eye. The lenses move slightly with blink, but I never change the lens fit at the dispense, because the lens fitting relationship could be changed within a week or so.

He is coming back in a few weeks for a follow up visit, and we will reassess his vision and the fit of the lens at that time. He is also going to be one of our patients at the Global Specialty Lens Symposium workshop, so if you are attending the workshop, we will be able to see the progression of his interesting case! Thank you Visionary Optics for the Latitude scleral lenses - we can't wait to see how he does over the next few weeks and also at the workshop!