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

By Ronald K. Watanabe OD FAAO

This scientific guide offers universal touch lens issues of step by step therapy ideas. 40 case experiences hide more than a few difficulties from easy becoming dilemmas to opposed results of touch lens put on. each one case starts with a presentation of signs and symptoms, together with a case heritage and goal try out findings and ends with the author's analysis and dialogue.

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The patient then knows which lens is which before insertion. However, the black dot often rubs off with daily cleaning, especially when using abrasive cleaners such as Boston Cleaner. A final strategy to help the patient is to order two different lens colors: green for the right eye, blue for the left eye. This foolproof method is readily accepted by all but light blue irised patients. 1–3 If the patient were underminused in the right eye, the left eye would not have a plus OR nor would the fluorescein pattern change.

Visual Flare, Part 2 55 5. Schatz S. Improve visual performance with an aspheric multifocal. Contact Lens Spectrum. 2000;15(8):37–39. 6. Hodur NR, Gandolfi B, Wojciechowski S. Flare with rigid contact lenses. Contact Lens Forum. 1986;11(3):48–49. CASE 2-3 Sudden Onset Blur in One Eye Figure 2-3 History A 19-year-old Caucasian male presents at his first rigid gas-permeable (RGP) contact lens (CL) follow-up visit with complaints of suddenonset blurry vision in his right eye only that began 2 days earlier.

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.

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