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Keratoconus patient scleral lens follow up

Great one month scleral lens follow up today!

Our keratoconus patient was fit into the Latitude custom scleral lens in the right eye after cross linking.

At his follow up, he reports excellent vision, improved computer vision, and he is having scleral lens insertion success with the dalsey adaptives see green scleral lens stand.

Average wear time is 13 hours per day. He is using Boston simplus to clean/disinfect the lenses and non-preserved saline to fill the bowl of the lens.

Vision is 20/25+2 and the fit of the lens is beautiful!

His left eye is healing from the crosslinking procedure, but we will fit his left eye once we get the green light from Dr. Wellish or Dr. Ortiz.

Thank you Wellish Vision Institute for trusting us with this patient!

We love managing keratoconus cases with awesome doctors!

Scleral Lens Stand Helps With Insertion

dalsey+adaptivesDo you have EXTREME difficulty inserting your scleral lens?

  • Patients having difficulty inserting their scleral lenses with traditional devices may consider using a scleral lens stand.
  • Place your scleral lens on the plunger, which will be held up with a stand.
  • This allows full control of your eyelids from both hands!
  • Fill the scleral lens with non preserved saline and simply lower your eye to the scleral lens.
  • This is a great option for patients who have difficulty controlling their blink reflex, among other patients (patients with Parkinson’s or other Neuro disorders, or patients with one arm, etc.)

This has been an incredibly helpful tool in my office to assist patients with scleral lens insertion!

#sclerallens #scleralcontacts #sclerallensinsertion #howtoinsertaclerallens #ilovespecialtycontacts #helpingeyesonescleralatatime #keratoconus #keratoconuscontacta

Scleral lens insertion with a dental ring

You can insert a scleral contact lens with an o ring, or dental ring (orthodontic band)
▪️For patients who have difficulty using a plunger to insert their scleral lens, the use of an o ring or orthodontic band can be helpful.
▪️Simply place the O ring or orthodontic band on the tip of your index finger. Then, place your scleral lens on the device. Fill with non preserved saline, and apply the lens to your eye.
▪️This technique helps many patients who prefer to use only one finger to balance their lens. It also allows the other fingers on that hand to control the lower eyelid.
▪️O rings can be found at any hardware store (the cost is usually around 10 cents) and a pack of orthodontic bands can be found online (pack of 100 bands for around $7).
▪️This is a cheap and effective method to helping scleral lens wearers apply lenses!

@nkcforg @scleralsociety @keratoconusgroup #sclerallenses #scleralcontacts #ilovespecialtycontacts #helpingeyesonescleralatatime

Scleral lens insertion with the ezi ring

How the EZ I ring can help you insert your scleral or hybrid lens.

▪️The EZI applicator is a great product that I discovered during my Contact Lens Residency. The company gave us some free samples to try on patients.

▪️Dr. Ed Bennet and I conducted a study at the University of Missouri, where we compared 2 applicator devices – the EZI ring vs the traditional DMV plunger. The subjects found the EZI ring easier to use than the plunger, and the results were statistically significant.

▪️We submitted these results to the American Academy of Optometry, and we were selected to present a paper at the annual 2012 meeting.

▪️The EZI is a great resource for many scleral lens and hybrid lens wearers who have difficulty inserting their lenses.

▪️The founders of the company are great too. The story of how the EZI applicator came to be is really interesting – a scleral lens wearer had a 22 mm scleral lens (which is VERY large compared to most scleral lenses), and he was having difficult inserting the lens. His son, an engineer, devised an insertion tool to help his dad get this large lens in his eye. The idea of the EZI ring was born, and now they produce many of them to help patients all over the world!

@keratoconusgroup @scleralsociety @nkcforg #keratoconus #keratoconusawareness #keratoconussucks #ilovespecialtycontacts #gaspermeablecontacts #specialtycontactlenses #gplenses #helpingeyesonescleralatatime #hardcontacts #scleralsrule #sclerallensinsertion #hybridlensinsertion

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

Do you ever experience fogging with your scleral lenses?

Fogging can be from a variety of factors.

pexels photo 132943 orig

Fogging can be a result of tear film instability, dry eye, meibomian gland dysfunction, debris within the tear chamber of the lens, too much liquid in the tear chamber, or poor fit of a scleral lens.

If the fogging is due to your tear film or dry eye, that means your eye doctor may need to start a dry eye treatment program. You may require dry eye in office treatments, medicated eye drops or other modalities.

If the fogging is due to the fit of the scleral lens, your doctor may need to adjust the parameters of the lens to achieve a more ideal fit.

In other cases, the fit of the scleral lens may be excellent, but your eye produces extra mucous or debris. In this case, it may be necessary to remove the lens, rinse with preservative free saline, and then reinsert the lens.

Ask your eye doctor if you are experiencing fogging issues with your scleral lens. It could be from dry eye or a tear film issue, or it could be a problem with the actual fit of the scleral lens.