scholarly journals A case report of visual outcome in keratoconus with retinitis pigmentosa

2018 ◽  
Author(s):  
Chiun-Ho Hou ◽  
Yun-Wen Chen ◽  
Ken-Kuo Lin ◽  
Jiahn-Shing Lee ◽  
Lai-Chu See ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Retinitis Pigmentosa ◽  
Contact Lens ◽  
Contact Lenses ◽  
Life Quality ◽  
Visual Outcome ◽  
Visual Aids ◽  
Blurred Vision ◽  
Visual Rehabilitation

Abstract Background: It is uncommon to see retinitis pigmentosa in keratoconus patients. The main difficulty of visual rehabilitation for this is restricted visual field. We presented the treatment and gene screen of visual system homeobox 1 (VSX 1) gene in this case. Case presentation: A 24-year-old man with retinitis pigmentosa presented with progressively blurred vision. Slit lamp examination revealed Vogt’s striae over both eyes, and corneal topography indicated bilateral keratoconus. We had tested 5 exons of VSX 1 gene from him and the did not find mutation on direct sequence. To improve visual acuity, we prescribed keratoconus rigid gas permeable (RGP) contact lens for him with good efficacy. However, lens dislocation occurred occasionally. He could not find dislocated lens easily due to visual field restriction, so he asked for more stable visual aids. Therefore, we instead prescribed scleral lens (SL), which were more stable on the ocular surface and led to more stable vision. Visual acuity was also gained with SL, but the tolerance time for SL was shorter compared to that of keratoconus RGP contact lens. To compare the efficacy of these two lenses, we surveyed life quality using the National Eye Institute Visual Functioning Questionnaire – 25 in three situations: baseline, with keratoconus RGP contact lens, and with SL. Conclusion: The patient used the two lens types according to his needs, and benefited from vision rehabilitation with both keratoconus RGP contact lens and SL. Keywords: keratoconus; retinitis pigmentosa; rigid gas permeable contact lenses; scleral lenses.

scholarly journals Reverse Geometry Hybrid Contact Lens Fitting in a Case of Donor-Host Misalignment after Keratoplasty

2013 ◽  
Vol 2 (2) ◽  
pp. 69-72
Author(s):  
Rafael J Pérez-Cambrodí ◽  
Pedro Ruiz-Fortes
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Anterior Segment ◽  
Successful Outcome ◽  
Imaging Evaluation ◽  
Visual Rehabilitation ◽  
Distance Visual Acuity ◽  
Fitting In ◽  
Contact Lens Fitting

ABSTRACT Purpose To report the successful outcome obtained after fitting a new hybrid contact lens in a cornea with an area of donor-host misalignment and significant levels of irregular astigmatism after penetrating keratoplasty (PKP). Materials and methods A 41-year-old female with bilateral asymmetric keratoconus underwent PKP in her left eye due to the advanced status of the disease. One year after surgery, the patient referred a poor visual acuity and quality in this eye. The fitting of different types of rigid gas permeable contact lenses was performed, but with an unsuccessful outcome due to contact lens stability problems and uncomfortable wear. Scheimpflug imaging evaluation revealed that a donor-host misalignment was present at the nasal area. Contact lens fitting with a reverse geometry hybrid contact lens (Clearkone, SynergEyes Carlsbad) was then fitted. Visual, refractive, and ocular aberrometric outcomes were evaluated during a 1-year period after the fitting. Results Uncorrected distance visual acuity improved from a prefitting value of 20/200 to a best corrected postfitting value of 20/20. Prefitting manifest refraction was +5.00 sphere and .5.50 cylinder at 75°, with a corrected distance visual acuity of 20/30. Higher order root mean square (RMS) for a 5 mm pupil changed from a prefitting value of 6.83 μm to a postfitting value of 1.57 μm (5 mm pupil). The contact lens wearing was referred as comfortable, with no anterior segment alterations. Conclusion The SynergEyes Clearkone contact lens seems to be another potentially useful option for the visual rehabilitation after PKP, especially in cases of donor-host misalignment. How to cite this article Pérez-Cambrodí RJ, Ruiz-Fortes P, Llorens DPP. Reverse Geometry Hybrid Contact Lens Fitting in a Case of Donor-Host Misalignment after Keratoplasty. Int J Kerat Ect Cor Dis 2013;2(2):69-72.

scholarly journals Silicone Hydrogel Miniscleral Contact Lenses after Corneal Collagen Crosslinking for Post-LASIK Keratoectasia

2014 ◽  
Vol 3 (3) ◽  
pp. 127-129
Author(s):  
Boris Severinsky
Keyword(s):  
Contact Lens ◽  
Contact Lenses ◽  
Visual Outcome ◽  
Visual Rehabilitation ◽  
Collagen Crosslinking ◽  
Silicone Hydrogel ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

ABSTRACT Purpose To report successful visual rehabilitation of post refractive surgery keratoectasia shortly after corneal collage crosslinking (CXL) procedure achieved with silicone hydrogel mini-scleral (SHmS) contact lens. Materials and methods A 29-year-old woman attended to our clinic with complaints on decreased vision in her left eye. Twelve years earlier she underwent bilateral laser-assisted in situ keratomileusis (LASIK) procedure for myopia correction. Corneal topography revealed bilateral central keratoectasia with maximal keratometry values of 55.4 Diopter (D) for her right eye and 59.7 D for the left, corneal thicknesses were 422 and 443 respectively. The patient underwent an uneventful CXL procedure in her left eye and was fitted with SHmS lens 5 weeks later. The lens was designed to rest over the patients’ sclera and perilimbal cornea and vault the central cornea with minimal support over it. Results SHmS lens fitting resulted in significant subjective improvement in visual acuity (from 20/200, unaided to 20/25, contact lens corrected). The patient was able to wear the lens upto 10 hours a day with stable contact lens corrected vision. No contact lens related complications, such as edema or neovascularization were observed during 3 months follow-up period. As a result of successful restoration of vision in the CXL-treated eye, the patient was scheduled for the procedure in her other eye. Conclusion SHmS contact lens should be considered as an option for the visual rehabilitation of corneas shortly after collagen corneal crosslinking procedure. This novel contact lens modality made from flexible and highly gas permeable material minimizes contact lens influence on corneal recovery after CXL and provides an excellent visual outcome. How to cite this article Severinsky B. Silicone Hydrogel Mini-scleral Contact Lenses after Corneal Collagen Crosslinking for Post-LASIK Keratoectasia. Int J Kerat Ect Cor Dis 2014;3(3):127-129.

Contact Lens Fitting in Patients with Keratoconus – A Retrospective Assessment of 200 Patients

2021 ◽  
Author(s):  
Kathrin Richter ◽  
Theresia Jullien ◽  
Ulrike Klühspies ◽  
Achim Langenbucher ◽  
Berthold Seitz ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Visual Outcome ◽  
Drop Out ◽  
Back Surface ◽  
Corneal Transplant ◽  
Wide Range ◽  
Fitting In ◽  
Contact Lens Fitting

Abstract Background and Purpose Nowadays, keratoconus (KC) is very well treatable in a stage-oriented manner. A wide range of designs and materials of contact lenses (CL) are available for the treatment of KC. The aim of this study was to evaluate the possibilities, the possible challenges and the visual outcome of lens fitting in KC eyes. Patients and Methods This retrospective study includes data from 200 patients who received a lens fitting trial in our contact lens service between 2006 and 2016. We documented ophthalmological parameters, the type of prescribed CL, the number of required trial lenses and possible causes of the failure of the lens fitting. Results The mean age at initial lens fitting was 33.9 ± 12.5 years. In 98.8% of the cases, the fitting was performed with rigid gas permeable lenses, in 90.1% with four-curve lenses. Of the total number of aspheric lenses prescribed, 87.5% were fitted in keratoconus stages “1” to “2” (topographic keratoconus classification; Oculus Keratograph). Back surface toric lenses or bitoric lenses were fitted to 61.7% in keratoconus stages “2 – 3” to “4”. Before patients received their final CL, a median of 2 trial lenses were required (max. 16). Mean visual acuity with lens correction was 0.8 ± 0.2 at the initial fitting, mean visual acuity with glasses correction was 0.5 ± 0.3. In 7.7% of the eyes, the KC lens fitting was discontinued due to the advanced stage of keratoconus, requiring a corneal transplant. Reasons for discontinuing contact lens fitting included lens intolerance (2.3%), application problems (0.3%) or acute corneal hydrops (0.3%). Discontinuation of lens wearing due to incompatibilities or application problems occurred in only four cases (1.1%) in the further course after lens fitting. Conclusions The use of contact lenses is an integral part of the stage-appropriate therapy of keratoconus. Good visual acuity can be achieved in all stages of keratoconus with a low drop-out rate. In most cases, the adjustment is carried out with rigid gas permeable lenses with a four-curve geometry. In initial stages, aspherical lenses may be sufficient. Toric lenses can be fitted in advanced stages when rotationally symmetrical lenses cannot achieve a satisfactory fit. If contact lenses have been successfully fitted, there are only a few cases in which patients abandon their contact lenses because of intolerance.

scholarly journals Corneal Thinning after Contact Lens-related Infective Keratitis

2014 ◽  
Vol 3 (2) ◽  
pp. 95-98
Author(s):  
José Salgado-Borges ◽  
Renata Siqueira ◽  
Raquel Almeida ◽  
Filipa Rodrigues ◽  
Matheus Santos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Case Reports ◽  
Corneal Thickness ◽  
Corneal Opacity ◽  
Infectious Keratitis ◽  
Visual Rehabilitation ◽  
First Case ◽  
Corneal Thinning

ABSTRACT Purpose To describe two cases of contact lens-related infectious keratitis with secondary corneal thinning. Material and methods Case reports and review of the literature. Results The first case is of a 13-year-old girl, contact lens user, admitted for acute corneal infection in her right eye (OD). Seven years after treatment, she presented with corneal thinning and flattening with uncorrected distance visual acuity of 20/30 OD; thinnest value was 363 µm in OD and 513 µm in the left eye (OS). The second case is a 22-year-old male, cosmetic contact lens user, first presented with severe keratitis in OD. One year after treatment, the eye was quiet with moderate corneal opacity; corneal thickness was 228 µm OD and 561 µm OS. Ectasia was identified due to the protrusion and steepening with an irregular curvature pattern. Rigid gas permeable (RGP) contact lens fitting enabled visual acuity of 20/25 OD. Conclusion Corneal melt with secondary stromal loss and thinning may lead or not to secondary ectasia. Visual rehabilitation is possible with RGP contact lenses despite corneal opacity. The risk of infectious keratitis among contact lenses users should be considered. How to cite this article Almeida R, Rodrigues F, Santos M, Siqueira R, Contarini P, Salgado-Borges J, Ambrosio R Jr. Corneal Thinning after Contact Lens-related Infective Keratitis. Int J Kerat Ect Cor Dis 2014;3(2):95-98.

Possibilities of scleral lenses for visual rehabilitation of patients with corneal scars

2021 ◽  
pp. 157-161
Author(s):  
O.I. Ryabenko ◽  
◽  
O.M. Selina ◽  
E.M. Tananakina ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Efficacy And Safety ◽  
Visual Rehabilitation ◽  
Optical Correction ◽  
Vision Correction ◽  
Post Traumatic ◽  
Key Words Cornea ◽  
Irregular Astigmatism ◽  
Spectacle Correction

Purpose. To analyze the efficacy and safety of SCL in patients with corneal cicatricial changes and other concomitant conditions. Material and мethods. The study included 19 patients (20 eyes) with cicatricial deformity of the cornea of various etiology, who were fitted with scleral contact lenses. Results and discussions. The use of SCL is possible in post-traumatic pathology, such as corneoscleral scars with or without aphakia, as well as after keratitis with an outcome in cicatricial deformity, cicatricial changes after a burn. A significant increase in visual acuity compared with spectacle correction has been proven. Depending on the topography of the scar, it is possible to select scleral lenses such as Oblate and Prolate, as well as with different versions of the support zone: both toric and quadratic. Conclusion. Scleral lenses can be successfully used for optical correction in patients with cicatricial changes in the cornea and other concomitant post-traumatic conditions of ineffectiveness of other methods of visual rehabilitation. Key words: cornea, lenses, vision correction, contact lenses, visual rehabilitation, scleral lenses, corneal scars, post-traumatic astigmatism, aphakia, keratitis, toric lenses, quadratic lenses, astigmatism, irregular cornea, regular cornea, regular astigmatism, irregular cornea, irregular astigmatism, prolate, oblate.

scholarly journals Preliminary Clinical Exploration of Scleral Lens Performance on Normal Eyes

2018 ◽  
Vol 2 (2) ◽  
pp. e14-e21
Author(s):  
Melissa Barnett ◽  
Jonathon Ross ◽  
Blythe Durbin-Johnson
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Healthy Subjects ◽  
Contact Lenses ◽  
Front Surface ◽  
Contact Lens Wear ◽  
Factors Associated ◽  
Rigid Contact ◽  
Lens Wear ◽  
Spectacle Correction

Abstract Objectives: The purpose of this study was to evaluate the performance (i.e. vision, comfort and fit) of spherical and front-surface toric scleral lenses in subjects with regular, healthy corneas. Methods: Scleral lenses were fitin the eyes (n = 16) of healthy subjects (n = 9) with regular corneas, absent of pathology, and studied using an observational, multi-visit design. Lens fit was objectively evaluatedby an experienced practitioner.Following 1 month of successful lens wear, participants completedsubjective satisfaction surveys regarding the scleral lens wearing experience. Results:  According to participant surveys, scleral lenses were subjectively preferred over soft toric or gas permeable contact lenses in 88% of eyes, including in all eyes fit with a front-surface toric scleral lens (n = 3). Seventy-five percent (75%) of eyes achieved visual acuity of 0.1 logMAR or better, while all eyes with prior spectacle wear achieved visual acuity with a scleral lens within 1 Snellen line of spectacle correction. Seventy-five percent (75%) of eyes achieved good subjective comfort with a scleral lens. No participants reported poor subjective vision and/or comfort. Conclusions:  Our findings suggest that subjects preferred the performance of a scleral lens (spherical or front-surface toric) compared to a soft toric or gas permeable contact lens. Moreover, scleral lenses may provide a viable, alternative contact lens modality option for patients considering discontinuation of traditional soft toric and/or rigid contact lens wear; so long as the factors associated with hypoxia remain minimized. Key Words:  scleral lens; scleral contact lens; front-surface toric scleral lens; lens performance; normal eyes; healthy eyes

scholarly journals Visual rehabilitation of patients with irregular cornea

The Eye ◽  
2019 ◽  
Vol 125 (2019-1) ◽  
pp. 26-32 ◽  
Author(s):  
Alexander Myagkov ◽  
Elena Belousova ◽  
Natalya Ignatova ◽  
Oksana Petrova
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Visual Comfort ◽  
Irregular Surface ◽  
Visual Rehabilitation ◽  
Main Method ◽  
Landing Zone ◽  
Optical Correction ◽  
Selection Of ◽  
Spectacle Correction

Purpose: To estimate the possibility of optical correction of an irregular surface of a cornea at primary ectasia (keratoconus) and secondary ectasia (a consequence of radial keratotomy (RKT) and Keratoplasty) for improvement of the maximum of visual acuity. Material and methods: In the study the scleral gas-permeable lenses (SGCL) were fitting by the 60 patients, it was 45 men and 15 women from them. The 46 patients had various stage of keratoconus and 14 patients had the keratectasia after RKT. On the 5 eyes of the patients was carried out keratoplasty earlier. Criteria of successful selection of SGCL considered achievement of steadily high visual acuity, comfort of carrying and the optimal clearance in apical zone, in the limbal and landing zone on the conjunctiva also. The results: In the course of the study, the maximum visual acuity in all patients was achieved with mini-SGKL correction irrespective of type of keratoektasia. All patients observed visual comfort compared with spectacle correction or correction with other types of contact lenses. Conclusion: Scleral gas-permeable contact lenses are the main method of correction at patients with irregular corneas and provide the best visual acuity.

scholarly journals The impact of wearing single vision soft contact lenses on the peripheral refractive error

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2803
Author(s):  
Kareem Allinjawi ◽  
Sharanjeet-Kaur Sharanjeet-Kaur ◽  
Saadah Mohamed Akhir ◽  
Haliza Abdul Mutalib
Keyword(s):  
Visual Field ◽  
Open Field ◽  
Refractive Error ◽  
Contact Lens ◽  
Contact Lenses ◽  
Soft Contact ◽  
Soft Contact Lenses ◽  
Single Vision ◽  
The Right ◽  
The Impact

Aim: The purpose of this study was to determine the changes in the relative peripheral refractive error produced by soft single vision contact lenses in myopic schoolchildren. Methods: 27 myopic schoolchildren aged between 13 to 15 years were included in this study. The measurements of central and peripheral refraction were made only on the right eye using a Grand-Seiko WR-5100K open-field autorefractometer without contact lens (WL), and with wearing single vision contact lens (SVCL). Refractive power was measured at center and horizontal eccentricity between 35° temporal to 35° nasal visual field (in 5° steps). Results: SVCL showed an increase in peripheral hyperopic defocus at the nasal and temporal visual field compare with baseline, but this change was not statistically significant (p=0.129). Conclusion: Wearing single vision soft contact lenses increases the relative peripheral hyperopic defocus in myopic schoolchildren.

Twenty-year outcomes in patients with newly diagnosed glaucoma: mortality and visual function

2018 ◽  
Vol 102 (12) ◽  
pp. 1663-1666
Author(s):  
Christopher King ◽  
Justin C Sherwin ◽  
Gokulan Ratnarajan ◽  
John F Salmon
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Survival Curve ◽  
Visual Outcome ◽  
Field Analysis ◽  
Time To Death ◽  
Kaplan Meier ◽  
Two Stages

Background/aimsTo determine the mortality within 20 years of diagnosis of chronic open-angle glaucoma (COAG) and visual acuity and visual field progression of a cohort followed for 20 years.MethodsTwenty years following the diagnosis of COAG in 68 of 436 (16%) patients seen in a glaucoma case-finding clinic, visual and mortality outcomes were audited from medical records. Causes of death were obtained from general practitioner records and death certificates. Probability of death was calculated using a Kaplan-Meier survival curve. The visual field of each eye of survivors was graded using a nine-stage severity scale. Visual outcome was analysed at the 20-year follow-up visit.ResultsFrom 68, 14 (21%) were lost to follow-up. In the remaining 54, 20 (37%) were alive 20 years after diagnosis. Of 63% who died, mean age of death was 84 years, most commonly due to vascular disease. Mean age at presentation of those who died was 73.7 years versus 63.2 years for survivors (P=0.001). The median time to death was 16 years. On visual field analysis, nearly half (48.9%) of eyes did not deteriorate, but 28.3% eyes deteriorated by more than two stages. Those who died had worse final visual acuity than survivors (P<0.001). Three who died were registered severely visually impaired mainly from macular disease, but no survivors were registered (P<0.001).ConclusionIn this cohort, approximately two-thirds of patients with glaucoma died within 20 years of diagnosis. In most older patients with glaucoma, the overall goal of preventing visual handicap and blindness is achievable 20 years after diagnosis.

scholarly journals Submacular Cysticercosis Successfully Treated through Conservative Management: Case Report

2020 ◽  
Vol 11 (2) ◽  
pp. 315-321
Author(s):  
Renata García Franco ◽  
Alejandro Arias Gómez ◽  
Juvenal Guzman Cerda ◽  
Marlon García Roa ◽  
Paulina Ramirez Neria
Keyword(s):  
Visual Acuity ◽  
Medical Management ◽  
Central Nervous System Involvement ◽  
Vitreoretinal Surgery ◽  
Visual Outcome ◽  
Clinical Findings ◽  
Ophthalmological Examination ◽  
Blurred Vision ◽  
Elevated Lesion ◽  
The Right

Appropriate medical management can be an alternative in those patients with submacular cysticercosis in whom achieving good visual outcome with vitreoretinal surgery is not possible. We report the case of a 25-year-old female who presented complaining of blurred vision in her left eye associated with photopsias and metamorphopsias of 3 months duration. Initial visual acuity in the right eye was 20/20 and 20/100 in the left eye. Upon indirect ophthalmoscopy in the left eye, a yellow-white, dome-shaped, elevated lesion with foveal involvement was observed. The rest of the ophthalmological examination proved normal. With clinical findings and images, submacular cysticercosis was diagnosed, and vitreoretinal surgery was suggested. Nevertheless, the patient did not accept the treatment; therefore, medical management was initiated. Central nervous system involvement was ruled out, and treatment with praziquantel and systemic prednisolone was initiated. Cysticercosis was resolved with significant improvement of her symptoms and visual acuity.

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