|
Want to receive an email reminder of the symposium?
GPs and Young People
Links to Case Studies:
Case 1
By: Dr. John Rinehart
I first examined JN, an 8 year old hockey goalie, in April 2006.
Unaided DVA OD, OS 20/70
Subjective Refraction OD -1.75 sphere 20/20
OS -2.00 sphere 20/20
K reading OU 44.25/45.75 @ 090
Various correction options were discussed including spectacles, soft lenses GP lenses and OrthoK. The patient and parents liked the option of OrthoK because she is a very athletically active child and to be without any vision correcting appliance seemed to offer the most advantages.
I did explain to the patient and parents that I did have one reservation about the potential success of this therapy. From the K’s and subjective refraction it appears that there could be as much as 1.50 D of residual astigmatism. The final commitment to this treatment was reserved until we had performed an overnight diagnostic fitting.
The initial diagnostic lens has a base curve of 8.13, 10.6 diameter with a 7.63 mm alignment curve radius. The topographic results of one night of wear are shown below.
The treatment zone is reasonable well centered. Unaided distance acuity at one day OD 20/20, OS 20/20 -2. K readings OU 42.00/42.50 @ 090 zero distortion.
After 7 months of overnight orthok lens wear she wears the lenses 5 nights per week and is very satisfied with her vision.
Unaided DVA OD, OS 20/20
Subjective refraction OD, OS +0.50 sphere
K-readings OD, OS 43.00/43.00 @ 090
Topography (below) continues to show a well centered treatment zone.
After approximately 4 years of overnight orthok lens wear JN’s unaided distance acuity is OD, OS 20/20, K readings OU 43.00/43.25 @ 090 zero distortion. Topography continues to show a well centered treatment zone.
Case 2
By: Dr. John Rinehart
TB a 16 year old male first consulted me in 2006. He had recently been diagnosed with keratoconus. After doing on-line research his mother was quite upset because she read that her son would be blind in 5 years. It is important that we guide our patients to reliable sites for quality information, obviously this would include GPLI and National Keratoconus Foundation websites.
Subjective refraction:
OD -5.00 -1.00 x 150 20/30
OS -7.00 -2.00 x 005 20/40
Keratometry:
OD 49.50/53.50 @ 105 #2 distortion
OS 53.00/58.00 @ 085 #3 distortion
The left cornea shows a small central scar and the right cornea is clear.
Initial topography:
Diagnostic fitting was done using Rose K diagnostic lenses.
The initial lenses ordered were:
| | Base | Power | Diam | Periphery |
| OD | 6.40 | -6.75 | 8.7 | standard |
| OS | 6.10 | -9.50 | 8.7 | 1 step flat |
These lenses provided 20/20 DVA OD, OS and good comfort throughout the day. He wears the lenses an average of 12-14 hours per day.
These lens parameters served TB well for about 2 years, then it became necessary to steepen the base curves in order to avoid excessive apical touch. The right eye is showing the most change.
At his latest visit he is beginning to show some apical scarring on the right eye but no notable change in the scarring on the left eye.
Currently his best corrected acuity is OD 20/40, OS 20/25.
Lenses currently worn: Rose K
| | Base | Power | Diam | Periphery |
| OD | 5.10 | -20.00 | 8.7 | 1/2 step flat |
| OS | 5.95 | -11.50 | 8.7 | 1 step flat |
Most recent topography:
Links to Case Studies:
|
