Objective:

To document the management of keratoconus in a patient through various contact lens fittings over time.

Approach:

• Patient History: The patient was first examined in 1997 with toxoplasmosis, amblyopia, and central corneal scarring in the right eye.
• Lens Fitting: Initially fitted with a specialized bicurve rigid gas permeable lens for keratoconus, later refitted with large intralimbal GPs in both eyes.
• Vision Assessment: Despite the right eye's lack of central vision, the patient reported improved functional peripheral vision.
• Lens Specifications: Intralimbal GP lenses were fitted with specific parameters to enhance tear exchange and maintain corneal health.
• Follow-Up: In 2019, contact lens wear was deemed contraindicated for the right eye due to corneal integrity risks, leading to a refit with a scleral lens.

Key Findings:

• The patient experienced improved peripheral vision despite advanced keratoconus.
• Intralimbal GP lenses provided stability and comfort while maintaining corneal health.
• Modern scleral lenses offer functional vision improvements even in eyes with poor central acuity.

Interpretation:

This case highlights the patient's experience with different contact lens technologies and their impact on vision.

Limitations:

• The study is based on a single patient case, limiting generalizability.
• Long-term outcomes of scleral lens use were not detailed.

Conclusion:

The case demonstrates how specific contact lens designs have improved functional vision for a patient with keratoconus.

Sources:

• Oxsight
• Science News Explore
• University of Iowa