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Case Studies for March 12 Online Symposium
Contemporary Orthokeratology
with John M. Rinehart, O.D., FAAO,
and Roger Tabb, O.D.

After reviewing
the case studies,
click here to visit
the Online Symposium room
March 12,
9:00-10:30 pm
Eastern

 

CASE ONE

Case History

  • DC is a 33 year old white female
     
  • Contact lens wearing history: she has 6 year DW soft lens wear
     
  • Reason for OrthoK: Lens life is becoming very short
     
  • No Medications
     
  • Unaided DVA       OD 20/70       OS 20/70
     
  • Subjective Refraction:    OD -1.50 - 0.50 x 090 20/20
                                               OS -1.75 sphere 20/20
     
  • K's    OU 43.00/43.00 @ 090
     
  • HVID    11.3 mm OU
     
  • Diagnostic lens fitting       BC 8.54, AC 7.94, Diam. 10.0mm OU
Lenses ordered for patient:ODOS
Base Curve8.288.33
Power+0.75+0.75
Diameter10.610.6
Alignment curve7.947.94
   

<< Prefit topography

Day One Visit

  • Unaided DVA     OD 20/20     OS 20/20
     
  • Subj Ref     OD +0.25 sph 20/20      OS +0.50 sph 20/20
     
  • K's      OD 42.00/42.50 @ 090      OS 42.00/42.00 @ 090

<< One day topography

Two Month Visit

  • Unaided DVA      OD 20/20      OS 20/20
     
  • Subj ref      OD Plano sph 20/20      OS Pl - 0.50 x 090 20/20
     
  • K's      OD 42.00/42.25 @ 090      OS 42.50/42.25 @ 090

<< Two month topography

CASE TWO

Case History

  • LG is a 38 year old white female
     
  • Contact lens wearing history 17 years of soft lens wear
     
  • Reason for OrthoK: correction has increased each of the last 5 years
     
  • Meds Flonase and Allegra for allergies
     
  • Unaided DVA      OD 20/80      OS 20/80
     
  • Subjective refraction       OD -1.75 - 0.25 x 090 20/20 
                                               OS -2.00 sphere 20/20
     
  • K's      OD 43.75/43.75 @ 090      OS 44.00/44.00 @ 090
     
  • HVID      11.2 mm OU
     
  • Diagnostic lens fitting      BC 8.49, AC 7.80, Diam 10.0 mm OU
Lenses ordered for patient:ODOS
Base Curve8.188.18
Power+0.75+0.75
Diameter10.010.0
Reverse curve7.207.20
Alignment curve7.807.80
   

<< Prefit topography

One Day Visit

  • Unaided DVA      OD 20/20      OS 20/20
     
  • Subj Ref      OD +0.25 sph 20/20      OS +0.50 sph 20/20
     
  • K's      OD 41.50/42.00 @ 090      OS 41.50/42.00 @ 090

10 Day Visit

  • Unaided DVA      OD 20/40      OS 20/30
     
  • Subj Ref      OD +1.50 - 1.75 x 065 20/20      
                          OS +1.75 - 1.25 x 125 20/20
     
  • K's      OD 42.50/43.00 @090 0 distortion 
                OS 42.50/44.00 @ 090 1/2 distortion

<< One week topography

Topography shows treatment zone decentered superiorly OU

New lenses were designed to improve centration. Sagittal depth of lenses increased by 5 microns
New lenses:ODOS
Base Curve8.188.18
Power+0.75+0.75
Diameter10.610.6
Reverse curve7.107.10
Alignment curve7.767.76

One Month Visit (one week after new lenses dispensed)

  • Unaided DVA      OD 20/20      OS 20/20
     
  • Subj Ref      OD +0.25 sph 20/20      OS Plano sphere 20/20
     
  • K's      OU 42.75/42.75 @ 090

2 Month Visit

  • Unaided DVA      OD 20/20      OS 20/20
     
  • Subj Ref     OD +0.75 sph 20/20      OS + 0.75 sph 20/20
     
  • K's      OD 41.75/42.00 @ 090      OS 42.00/42.00 @ 090

<< Two month topography

Patient's unaided DVA remains good with every other night wear.

3 Month Visit

Findings are unchanged from the 2 month visit.