Patient: |
TM |
History: |
52-year-old WF teacher/school administrator has worn RGPs for 15 years |
Activities: |
Computer use 2 hours per day. Hobby is reading. |
General Health: |
Inderal for tremors. No allergies to drugs or pollens. |
Ocular Health: |
Unremarkable. Grandmother had glaucoma. |
Current CL Parameters: |
OD: 7.40 BC -1.00 DS 9.0 Polycon II
OS: 7.40 BC -0.75 DS 9.0 Polycon II |
Refraction: |
OD: -1.75 DS +2.25 Add
OS: -1.25 DS +2.25 Add |
Ocular Measurements: |
Corneal Diameter (VID): |
12.0 mm, OU |
Pupil Size: |
Normal 4.50 mm, OU Low Illumination 5.5+ mm, OU |
Palpebral Appearance: |
10.5 mm, OU (lower lid @ limbus) |
Keratometry / Sim Ks: |
OD: 45.62 / 46.50 @ 101 (Do)
OS: 45.50 / 46.87 @ 87 (Do) |
Chief Complaint: |
Difficulty reading with contact lenses and needs to remove them to read. Does not wish to continue using reading glasses over contact lenses. |
Treatment: |
How do you approach this topic of multifocal contact lens option?
What design of contact lens would you use to give best range of near vision?
Why that type of lens?
What other options would you consider?
What other conditions should you consider when selecting a lens?
What technique would be most effective in determining which the initial lens design? |
Patient: |
ML |
History: |
62-year-old WF banker has worn rigid contact lenses for 23 years (PMMA, SV RGPs and failed with soft bifocal contact lenses). |
Activities: |
Include use of computer (significantly more). Hobbies include exercise and reading. |
General Health: |
Hormone replacement therapy |
Ocular Health: |
Occasional dry eye symptoms. No allergies. |
Current CL Parameters: |
OD: 7.56 BC -2.00 DS 9.20 Diam. Paraperm O2
OS: 7.56 BC -3.00 DS 9.20 Diam. Paraperm O2 |
Refraction: |
OD: -2.25 DS +2.25 Add 20/20 dist & near
OS: -3.50 DS +2.25 Add 20/20 dist & near |
Ocular Measurements: |
Corneal Diameter (VID): |
12.0+ mm, OU |
Pupil Size: |
Normal 3.50 mm, OU Low Illumination 4.0 mm, OU |
Palpebral Appearance: |
9.20 mm, OU (lower 1.0 mm below limbus) |
Keratometry / Sim Ks: |
OD: 45.12 / 45.37 @ 33 (Do)
OS: 44.87 / 45.37 @ 81 (Do) |
Chief Complaint: |
Difficulty looking at computer screen since office expanded use of computers. Some discomfort related to dry eye symptoms. |
Treatment: |
What would you do to solve the problem?
Which type of lens would you use?
What material would you consider and why?
Any other concerns? |
