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Are Hard Contact Lenses Still Useful?

Are hard contact lenses still useful?

With the invention of scleral lenses, corneal gas permeable lenses may seem like a thing of the past. However, corneal gas permeable lenses still remain a very effective option for many patients.

We have the pleasure of seeing a patient with keratoconus. He was used to wearing a corneal GP lens for keratoconus, and wanted to remain in the same lens modality. His lens was 5 years old, however the fit still looked ok. There were some scratches and deposits on the lens surface, and there was some excessive touch on the apex of the cone.

Patient’s habitual contact lens (unknown parameters)

Based on the topography, we decided to try the Rose K 2 lens. This corneal gas permeable lens is great for patients with nipple cones and oval cones. He falls into the mild/moderate category of keratoconus, so we thought this was a good lens to try first.

The topography shows a mild/moderate keratoconus with a nipple/central cone

Based on the fitting guide, we chose the base curve that we equal to his average K. The average K was 6.96mm so we selected the 6.9mm lens in the Rose K 2 fitting set.

When we placed the lens on the eye, it looked great! We were super happy with the fit and he was able to see 20/20 in this lens. Usually, we need to try several lenses on to get the perfect fit, but we really lucked out today! The lens was very well centered with good edge alignment. There is a very light feather touch on the apex of the cone, which is visible with the wratten filter.

The Rose K 2 lens was very well centered.

Stay tuned for his dispense!


Corneal Transplant Patient Fit With Gas Permeable Contact Lens

Kind referral of a corneal transplant patient from Dr. Shibiyama from UCLA/Jules Stein!

Older gentleman with a history of keratoconus in each eye. He had bilateral transplants back in the 1970’s and 1980’s and they held up for quite some time!

He also has a history of glaucoma with bleb surgery in each eye, and a shunt in the right eye.

The right eye underwent cataract surgery 2 years ago, and also received a new corneal transplant in March, and is ready to be re-fit into a new specialty contact lens.

The left eye transplant looks great, however, due to a large cataract, his vision is limited in that eye. He is wanting to get the right eye fit with a contact lens prior to proceeding with cataract surgery in the left eye.

The left eye has a hugely elevated bleb, so the corneal lens was specifically designed by Dr. Shibiyama to decenter laterally and inferiorly to protect the bleb.

The topography did not look severely irregular in the right eye, so I chose the ACE corneal gas permeable fitting set. The 7.0 base curve actually centered quite well, and I was pleased with the fluorescein pattern. With an over-refraction, he could achieve 20/80 vision. Despite a beautiful transplant and clear IOL, the vision is limited due to his advanced glaucoma.

With the help of Art Optical expert consultants Bethany and Erik, we designed the lens and got it ordered. Will keep you posted on his results!

High myopia patient fit into scleral contact lens

Thank you Dr. Isozaki for sending us this fun case!

34 year old Asian male was seen at UCLA by my good friend and classmate, Dr. Veronica Isozaki. He has a long history of corneal gas permeable lens wear, since he was about 10 years old.

After a very thorough case history, and after examining his current lenses, he mentioned that his last eye doctor in New York was attempting “orthokeratology daytime lenses.” I didn’t know what he meant until I saw the lens fit on his eye and the topographies.

The lenses both showed central bearing with midperipheral pooling (not a classic orthokeratology pattern, but I can see what he meant by ‘daytime orthokeratology lenses.” The left eye also shifts during blink which causes a chance in his vision.

We reviewed a variety of lens options extensively, and we decided to attempt an oblate scleral lens for now. I could attempt to redesign lenses based on his current topography, but the artificial shape might cause me to chase the lens fit over and over again. I recommended starting fresh with a scleral lens and we can monitor his corneal “unmolding” and if he truly wants to go back to the corneal gas permeable lenses, we will have a much better baseline.

The over-refraction was not attempted due to the autorefract data being -22.25 in the right eye and -22.75 in the left eye.

With an oblate design and also adjusting the base curve, we were able to decrease the power to about -16.00.

The first lens will be sort of a custom diagnostic lens. He knows that the shape of his eye and potentially the power will need to be adjusted as things progress. Will keep you posted on his results!

What to expect during a scleral lens fitting

What to expect during a scleral lens fitting:

Full video on YouTube:

▪️Your Doctor will take several images and measurements to determine the best lens for your eye.

▪️Then, a series of scleral lenses may be placed on the eye.

▪️The Doctor will evaluate the fit with the microscope and other imaging to determine if any changes are needed.

▪️They will then check your vision to determine what power to add to the lenses.

#eyeexam #optometria #optometrylife #optometrists #ophthalmology #eyeclinic #medicine #eye #optometrist #doctor #womeninoptometry #eyecareprofessionals #ilovespecialtycontacts #eyes #optometrista #scleralens #scleralcontacts #keratoconus #contactlenses #eyecare #eyedoctor #customcontacts #eyehealth #vision @oculus_usa @optovueoct @scleralsociety

Radial keratotomy and scleraL lenses

Update on our 79 year old patient!

▪️If you recall, our RK patient (with moderate cataracts OU and sutures OD) returned for her 2 week follow up after her dispense.

▪️With her Latitude custom scleral lenses, she was able to achieve 20/25- in the right eye and 20/20- in the left eye (despite the air bubble in the lens).

▪️She had adequate central clearance in each eye and the edges were still perfectly aligned.

▪️She had a few issues in the beginning with insertion but after the first 4 days she became proficient.

▪️We reviewed her lens care system and she was following the prescribed protocol perfectly.

▪️She is incredibly happy with her vision with the lenses, and she has recently started to make jewelry again.

▪️She saw Dr. Wellish the day prior, and he was pleased with the state of her eyes too!

▪️Grateful to be a part of this patient’s vision rehabilitation journey!

#rkscarring @scleralsociety #irregularcornea #radialkeratotomy #ilovespecialtycontacts #gaspermeablecontacts #specialtycontactlenses #gplenses #helpingeyesonescleralatatime #hardcontacts #scleralsrule @contactlensinstitute

How To Remove A Hard Contact Lens

contact on finger near eye

How to remove a gas permeable lens.

▪️There are a few different methods used to remove a gas permeable lens.

▪️First, there is the pull and blink method. Simply open your eye wide, then pull at the skin at the edge of your eyelid, and blink. The lens should pop off easily.

▪️Second, using your eyelids as shovels, position the very edge of the eyelid under the top and bottom of the contact lens and push to remove. This technique will require some practice because the eyelids must be at the proper position to get underneath the lens.

▪️Lastly, you can use a small plunger to remove the lens. Simply wet the tip of the small plunger with saline, press the plunger directly onto the lens and pull out to remove.

@keratoconusgroup @scleralsociety @nkcforg #keratoconus #keratoconusawareness #keratoconussucks #ilovespecialtycontacts #gaspermeablecontacts #specialtycontactlenses #gplenses @drstephaniewoo #hardcontacts #howtoremovecontacts #hardcontactlenses

How often should you replace your contact lens case?

cosmetic contact lens storage case 1

▪️Your contact lens should be discarded and replaced around every 90-100 days, or per your doctor’s instruction.
▪️Most manufacturers of contact lens solution recommend that the case is thrown away every 90-100 days.
▪️Typically, every time you purchase a new bottle of contact lenses solution, it will come with a new contact lens case.
▪️Be sure to throw away your old contact lens case everyone time you purchase a new box of solution or when your doctor recommends, whichever is soonest.
▪️Contact lens cases harbor lots of bacteria, which can result in serious eye infections.
▪️It is highly important to discard your contact lens case on a frequent basis!