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Case One Male, age 10 (mother is a -6.00 myope) 9/18/96 Unaided acuity:
Refraction:
K’s:
7/9/97 Hit in eye with a sparkler over 4th of July. Swabbed the inferior lid and fornix with Q-tip. FB problem resolved. At that time unaided acuity was:
2/26/99 Patient having difficulty with OD seeing at distance. Mom has concern because of her myopia. Mom wants to do myopia control lens. Unaided acuity:
Refraction:
K’s:
Patient fitted with a orthokeratology nightwear for control of myopia. Lens specifications for OD only. OD 8.232 +.75 10.2 6.2 .5 1.0 .24 eq 2 Patient seen following day after dispenses. VA unaided was OD 20/15 and OS 20/20. One-week later patient was seen uncorrected VA 15 OD and 20 OS. 6/14/99 Seeing great OD unaided all day, but is noticing OS poor. Refraction:
Fitted with same lens specification as OD. Result 20/15 unaided acuity OD, OS, OU. Refraction:
Now wears lenses one night per month , he maintains 20/15 at all times. Case Two 11/16/98 A 44-year-old male airline pilot. Started Orthokeratology with another Dr. unsuccessfully.. He stopped Orthokeratology in 1987. For the past several years he has experienced instability with his visual system. He would have -0.50 to +0.50 diopter fluctuations almost weekly. He was under two doctors' care at the time with one managing the contact lens care and the other managing vision training. The patient had been to me 15 years prior and self-referred himself back to me. Both lenses rode superior by 2.5 mm. The patient's goal was to keep his corneas from changing so he could wear his glasses immediately after removing his GP contact lenses and expect good acuity. Unaided acuity:
Refraction:
K’s:
Contact specifications worn in:
Refraction with contact lenses on:
No stain, edema, or pathology observed. Patient did not want to do NERO [ Nightwear End Result Orthokeratology]. He was very interested in myopia control and stability so he could depend on his glasses. We decided to modify his present lenses for power in the left eye and see if that would be adequate. -0.75 was added to his present lens and re-inserted. His next visit was 11-23-98 and he was pleased with the improvement the left lens repower had made. The lenses still rode high and functioned flat in pattern and performance even though they were 0.50 steeper than the flat K. had shown. A diagnostic work up was done with a T-compression design. The diagnostic lenses used were:
He was very pleased with the difference in the initial function of the diagnostic lenses compared to his lenses. Treatment: Lenses design
Initial experience as reported by patient on 12-6-98: “When I first got my lenses Friday, as the day wore on the acuity got better and better and better. There were no star bursts around lights at night now. Haloes have disappeared and no ghosting. The second night was not quite as good as the first night but was still super.” Was able to see with glasses immediately after removal. On 2-9-99 reported doing very well with vision remaining very stable. VA with lenses
Made the statement that he was now able to trust his vision at night. 5-19-99 Still doing very well. Notice slight drop in VA. The lenses were resurfaced and VA back up. Now:
Was seen 10 more visits with the last visit on 4-17-00. He complained of the correction being too strong and staining. Can’t see as well with readers either. Over refraction was:
Resurfaced OU and took OS from -2.00 to -1.87-. Reported much more comfort and more relaxed at both distance and near. |
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