Clinical Cases in Contact Lenses by Ronald K. Watanabe OD FAAO

By Ronald K. Watanabe OD FAAO

This medical guide offers universal touch lens issues of step by step therapy strategies. 40 case stories hide more than a few difficulties from easy becoming dilemmas to hostile results of touch lens put on. every one case starts off with a presentation of indicators and indicators, together with a case historical past and goal attempt findings and ends with the author's prognosis and dialogue.

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Clinical Pearls • Visual flare can be caused by a large pupil, small optic zone, or lens decentration. • Visual flare is common early in RGP adaptation. • Patient education prior to fitting RGP lenses helps reduce complaints of visual flare after initial dispensing. References 1. Hodur NR, Gandolfi B, Wojciechowski S. Flare with rigid contact lenses. Contact Lens Forum. 1986;11(3):48–49. 2. Hom MM. Rigid lens design and fitting. In: Hom MM (ed). Manual of Contact Lens Prescribing and Fitting with CD-ROM, 2nd ed.

In: Mandell RB (ed). Contact Lens Practice, 4th ed. Springfield, IL: Charles C Thomas, 1988:659–680. 2. Watanabe RK. Managing the astigmat with contact lenses. Contact Lens Spectrum. 1999;14(8):42–47. 3. Lindsay RG. 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.

Her ocular and medical histories are unremarkable. She takes multivitamins and has no allergies. 5 mm movement on blink, 1 mm lag movement, toric lens markings at 6:00 OD and OS, slow rotation with blinks OD, stable rotation OS (see Figure 1-6) Based on the clinical data, develop your list of differential diagnoses. Then, determine your final diagnosis and develop your treatment plan. Differential Diagnoses • Unstable toric lens rotation • Steep-fitting lens • Flat-fitting lens Poor Vision with a Toric Soft Lens 31 • Incorrect lens power • Surface deposits • Refractive shift OD Diagnosis Unstable toric lens rotation Management The patient’s symptoms suggest a lens that starts out fitting well but later tightens such that the lens rotates and remains off axis.

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