GP Fitting Case 1 - Discussion Item 1

a) While it is desirable to have the refractive and corneal cylinder match as close as possible, in most cases it isn't necessary. The tear layer behind the posterior lens surface will optically negate the corneal cylinder. Of more importance is that the refractive cylinder should be equal to or less than the corneal cylinder. If it is greater, the residual amount will need to be offset by utilization of a toric design. back

b) With-the-rule astigmatic patients are well suited for GP lenses due to the ideal lens movement along the steeper vertical meridian. During the blink cycle the GP lens follows the path of least resistance, which is the steepest curved meridian. While against-the-rule patients can also be fit with GP lenses, beware of post blink movement horizontally which may result in excessive lens decentration. back

c) When parents are successful GP wearers it is often desirable to also fit their children in this lens modality. back

d) It is not unusual to see 1st time wearers with this amount of astigmatism fit in spherical hydrogel lenses (usually to save expense of going into soft toric lenses). Fortunately this compromised vision can easily be corrected with a GP lens. back

e) All of the above are excellent reasons to recommend GP lenses to this patient. back