July 2014 Online Photo Diagnosis

July 2014 Online Photo Diagnosis

By Gregory W. DeNaeyer, OD, FAAO

This image shows the right eye of a 25-year-old female patient who has moderate chronic ocular surface disease. The patient is healthy and is on no medications other than birth control. Two years prior she reported to our office complaining of discomfort with her daily wear soft contact lenses. Currently, she is only able to tolerate daily disposable lenses for a few hours at a time to correct her myopia.

Besides chronic moderate superficial punctate keratitis (SPK) of both eyes, slit lamp findings include mild temporal scarring of her right eye. Her lids and adnexa are unremarkable. She has failed with conventional therapy including Restasis (Allergan).

After discussion, the patient decided to try scleral contact lenses. She was successfully fit with 16mm scleral lenses in parameters of OD 45.00D base curve, power –5.25 –1.25 X 076, 20/20 and OS 47.00D base curve, power –9.00 –0.75 X 084, 20/20. After dispensing the lenses, she wore them for a two-week trial. At a follow-up appointment, she reported that she was able to wear the lenses for a full day and was happy with the comfort and vision that they provided.