case reports: toric gp contact lenses ron watanabe, od
TRANSCRIPT
Case # 1: SR• 25-yo Asian medical student• Current soft lens wearer:
– OD Preference sphere– OS Preference Toric
• VA w/CL: OD 20/20, OS 20/50 unstable• Unhappy with vision in her left eye• Subjective Refraction:
– OD -1.75 -0.75 x 005, 20/20– OS -3.50 -4.25 x 175, 20/30
• Biomicroscopy: unremarkable
41.7541.75 45.3745.37 8585
-3.50 -4.25 175-3.50 -4.25 175
41.7541.75 45.3745.37-3.50-3.50-3.50-3.50
-7.75-7.75-7.00-7.00
0.250.25 0.250.25 0.750.75 0.750.75
41.5041.50 44.6244.62-3.25-3.25 -6.25-6.25
175175
Left eye: Spherical vs. Bitoric
Bitoric GPBitoric GP
Spherical GPSpherical GP
Boston EO 8.13 / -3.257.56 / -6.25
/ 9.5
VA 20/25
Case #2: AT• 39 yo Hispanic male salesman• Wears soft torics: decreased VA and comfort,
eyes are always red, has “oily tears”• HVID 11.5 mm• Keratometry:
OD 40.50 / 43.50 @ 82OS 41.75 / 42.75 @ 105
• Refraction:OD +4.00 -3.75 x 167, 20/25+OS +2.75 -1.25 x 13, 20/25+
• Lens designs?OD back surface toricOS spherical
3 D corneal cyl
1 D corneal cyl
3.75 D refractive cyl
1.25 D refractive cyl
Case #2: AT• Keratometry:
OD 40.50 / 43.50 @ 82 OS 41.75 / 42.75 @ 105
• Refraction:OD +4.00 -3.75 x 167 OS +2.75 -1.25 x 13
• Right lens BST – Optimum Extra (n = 1.431 = 28% over-correction = 3.84 D)40.25 (8.33) / +4.50 / 9.442.75 (7.89) 20/25, OR -0.25 DS
• Left lens spherical41.75 (8.08) / +2.75 / 9.4 20/25, OR -0.25 -0.50 x 15
• Lens fit:Lid attachment with apical alignment and spherical fluorescein patterns, good comfort, less redness towards the end of the day