Thank you for this fun referral from Dr. Casey at NVision!
63 year old female was looking for a new prescription for her multifocal corneal gas permeable lenses. She has been wearing GP lenses since she was a child and has always found it difficult to find a well-fitting lens that was coupled with great vision. During our testing, we discovered this patient has a moderately high minus prescription with about 4 diopters of limbal to limbal corneal astigmatism in the right eye and almost 5 diopters in the left. Her manifest Rx was OD: -4.25 -6.00 x 179 (20/30+1) and OS: -5.25 -6.00 x 001 (20/40+1). She also wanted to try to eliminate all need for glasses since she has been using OTC readers on top of her habitual multifocal contact lenses for near work.
Since she wanted to stick with corneal GP lenses, we discussed options for adding in near optics. Our patient stated that she had some success with the MF lenses and that she would like to see if an increase in add power would help with near work.
Due to her high amount of with-the-rule- astigmatism, we fit her in Valley Contax bitoric MF corneal GP lenses. We explained that this type of lens should allow for functional vision without OTC readers for about 70% of her daily routine.
After about 15 minutes of settling, her DVA was 20/20-2 OD, 20/20 OS, and 20/15 OU, and her NVA was 20/40-2 OD, 20/20-2 OS, and 20/20 OU. Both OD and OS lenses fit wonderfully with apical alignment, mild midperipheral bearing and moderate edge lift. The patient reported good comfort and vision and was so incredibly ecstatic in the office! She pulled her Kindle out and stated that it was the first time she could see the 12 point font without readers in years!