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Case 1

46 yo administrator. Wore GPs in past, last doctor changed her to SCLs. Never as happy with the vision. Now near becoming a problem as well. Frustrated.

Rx: OD -2.75 -1.00 x 180   Dominant eye             Ks: OD 42.00/43.00 @ 90

      OS -2.25 -1.50 x 180   Add +1.50 OU                   OS 42.00/43.25 @ 90

Pupils 4.5 mm in average room light
Palpebral fissure 11.5 mm
Lower lid at limbus

Trial fit with Essential Xtra (Blanchard Labs)

     OU 7.90 mm BC, -2.00, 9.5 mm LD, Series 2 Add

     Comfort good after 5 minutes ( no anesthetic)

     Vision: OD 20/20 with a -1.00 over-refraction

                OS  20/20 with a -0.50 over-refraction

       Near vision: J 1 OU with distance over-refraction in place

Positioned superior centrally, with upper lids.

     Movement was good in all positions of gaze.

Ordered: Essential Xtra , 7.90 mm BC OU, 9.5 mm LD OU, OD -3.00   Series 2

                                                                                       OS -2.50   Series 2

At dispensing, VA 20/20 distance and near.  Comfort was great.

Each lens fit and moved as the trial lenses had done.  Patient very happy.

Case 2

62yo technician. Current glasses wearer. Has used soft contact lenses in past for sports but not work. Has high visual demands.

Rx: OD -1.00 -0.75 x 180   Dominant eye          Ks: OD 43.50/44.50@90

      OS -1.25 -1.00 x 180   Add +2.25                     OS 43.50/44.75@90

Pupils 4 mm in average room light

Palpebral fissure 11 mm

Lower lid at limbus

Trial fit with Metro-Seg (Metro Optics)

 OD 7.80 mm BC, -3.00, 9.5 mm LD, +2.00 Add, 1.0 mm below geometric center,

 OS  7.70 mm BC, -3.00, 9.5 mm LD, +2.00 Add, 1.0 mm below geometric center,

      Both had 1 diopter prism @90

   Comfort good after 10 minutes without anesthetic use.

   Vision: OD 20/20 with a +2.00 over-refraction

              OS  20/20 with a +2.00 over-refraction

        Near vision was J 1 with an additional +0.50 OU

Both lenses positioned centrally with slight lid attachment and the segment at the lower pupil margin OD, slightly below the pupil margin OS.

Movement was good in all positions of gaze, with good translation up on downgaze.

Rotation was stable at 5 degrees nasal OU.

 Fluorescein pattern: alignment OD, with good peripheral clearance.

   OS showed a slight apical clearance with good peripheral clearance.

Ordered: Metro-Seg
 
OD: 7.80 mm BC, -1.00, 9.5 mm LD, +2.50 Add, 1.0 mm bgc, 1 diopter of prism @ 90.

OS: 7.75 mm BC, -1.00, 9.5 mm LD, +2.50 Add, 1.0 mm bgc, 1 diopter of prism @ 90.

At dispensing, comfort was good after 5 minutes.

     Vision was 20/20 OU at distance and near

    Both lenses positioned centrally with lid attachment. Each segment was at the lower pupil margin in primary gaze.  Movement was good in all positions of gaze, with good translation up on downgaze.  Rotation was stable at 5 degrees nasal OU.

    Fluorescein showed alignment OU with good peripheral clearance.

  The patient was advised to begin with 4 hours of wear on day one, increasing in two hour increments to a maximum of 14 hours.

He has continued to do well.

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