By Dr. Matthew Lampa, O.D., FAAO.
In the visual management of irregular astigmatism, the modern gas permeable contact lens can be life-changing. One of the more common ocular conditions resulting in irregular astigmatism is keratoconus, and a gas permeable contact lens – whether it be corneal or scleral – has become established as the standard modality by which these patients are managed visually.
This case exemplifies the visual importance of these medical devices and their dramatic impact on vision beyond what traditional spectacles are able to provide for these patients. However, this case goes beyond simply managing the irregular astigmatism, as it also shows how materials like those available from Contamac in the Optimum range can be manufactured in a grey colour, which can limit the amount of light entering the eye that may be visually distracting or produce light sensitivity for patients.
A 65-year-old male presented for annual evaluation with a chief concern of discomfort and light sensitivity for which he commonly wore sunglasses indoors. His ocular history was significant for keratoconus with mild corneal scarring in his left eye. His best-corrected visual acuity with spectacles was right eye 20/60 and left eye 20/200. He had habitually worn corneal gas permeable lenses in both eyes. His best-corrected visual acuity with his contact lenses was right eye 20/20- and left eye 20/25-. His habitual gas permeable contact lenses were well aligned in both eyes with plano over-refraction right and left eye.
The patient was successfully fitted with off-the-shelf soft contact lenses for piggybacking purposes in an effort to improve his comfort. Upon follow-up, he reported much improvement to his contact lens wearing comfort however his significant light sensitivity remained. It was decided to trial a gas permeable lens material available in a darkened colour. However, since he was now successfully wearing a piggyback modality, the search began for the highest oxygen permeable lens material with a grey colour, which was exclusively found in the Optimum line of materials from Contamac. The Optimum Extreme grey was selected and his habitual lenses were re-ordered, matching all previous parameters as the fit and vision – the only concern remaining was his significant light sensitivity.
After ordering and dispensing the lenses the patient reported a significant improvement to his light sensitivity and no longer needed sunglasses while indoors. The patient generally reported a much more comfortable and tolerable contact lens wearing experience.
This case highlights the creative way in which we can attempt to solve a patient’s visual needs and complaints with the numerous innovative products available in the marketplace today. The Optimum range of contact lens materials is offered in a variety of colours, oxygen permeabilities and wettability characteristics. This patient was very thankful to have all of his visual needs satisfied with the Optimum range and specifically with the Optimum Extreme in grey.
Thank you to Dr. Matthew Lampa, O.D. for contributing to Global Insight.