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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:

https://youtu.be/C-igXQ_J_KY

▪️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.

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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