Case Reports:Toric GP Contact Lenses

Ron Watanabe, OD

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

Case #1: Corneal Topography

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

Right eye: Spherical GP

• Spherical GP

Boston EO 7.90 / -1.50 / 9.5VA: 20/15

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