By Ronald K. Watanabe OD FAAO
This medical guide offers universal touch lens issues of step by step remedy strategies. 40 case experiences disguise a number of difficulties from simple becoming dilemmas to antagonistic results of touch lens put on. each one case starts off with a presentation of signs and symptoms, together with a case background and aim attempt findings and ends with the author's prognosis and dialogue.
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Extra info for Clinical Cases in Contact Lenses
JS wears her lenses on a daily wear basis with a maximum wearing time of 14 hours per day. The patient is compliant with the care of her lenses. 25 × 010, 20/15–1/6 • Biomicroscopy: OU central cornea clear, no staining, mild (<1/2 mm) perilimbal vascularization Based on the clinical data, develop your list of differential diagnoses. Then, determine your final diagnosis and develop your treatment plan. Differential Diagnoses • Flat soft contact lens causing cylinder misalignment due to excessive rotation during or after a blink • Cylinder misalignment due to prescribing wrong axis • Crisp vision not afforded by toric soft contact lens due to cylinder component in excess of sphere component Diagnosis The vision afforded JS is not acceptable with toric soft contact lenses.
1–5 In the office, modification tools can be used to change the power, polish the lens surfaces, change the edge shape, and change peripheral curves. At home, patients can also alter lens parameters if an abrasive cleaner is used with heavy finger pressure. Boston Original Cleaner was formulated with abrasive particles to remove hard protein deposits from silicone 64 Clinical Cases in Contact Lenses acrylate RGP materials. 1–4 The most effective way to prevent these lens parameter changes is patient education on proper daily cleaning technique.
Troubleshooting toric soft lenses. Contact Lens Spectrum. 2000;15(9):27–33. 4. Becherer PD. Toric lenses, then and now, some timeless pearls. Eyequest. 1991;1(1):14. 5. Lindsay RG, Bruce AS, Brennan NA, Pianta MJ. Determining axis misalignment and power errors of toric soft lenses. Int Contact Lens Clin. 1997;24(3):101–106. 6. Tomlinson A, Ridder WH, Watanabe R. Blink-induced variations in visual performance with toric soft contact lenses. Optom Vis Sci. 1994;71(9):545–549. CASE 1-7 Soft versus Rigid Toric Lenses Timothy B.