Contact Lens Options for Hyperope

[Excel-Lentes]

Hi,

I have been trying to get a good fit for a patient with a soft lens. His Rx is:

+1.00
+2.50

He previously wore F.Look Colorblends. He said his last pair started to move too much on his eye. He has worn brand of lens for 4 years without any problems. I tried a pair on him and sure enough they sink down way too much when looking up and have poor centration and slight edge lift. It is worse in the right eye than the left.

I then tried acuvue 8.3 (steeper) and the centration was worse. Next up was the 54% extreme H20 (13.6) and the same deal.

I am going through looking for other options in a steep base curve to get the lenses to stay centered. I have had this problem 1-2 times in the past and found nothing that worked.

Any suggestions would be appreciated (unless you recommend RGP's; that is not an option).

Thanks for your time>:idea:

[Dave Nelson]

What are the K readings? Have they changed? Are the mires clear and crisp? Why are you going steeper?

[Excel-Lentes]

Hi,

Sorry;

K's 43.50 @ 175 / 43.87 @ 85
43.75 @ 175 / 44.00 @ 85

K's are nearly identical to original K's.

Trying to go steeper to reduce excessive movement and lack of recentering.

[ziggy]

Try the O2 optix or another one of the SH lens. It has a 14.4 dia lens and should decenter much less. let us know what works.

[chip anderson]

Three ways to reduce movement: Go Steeper, Go larger, use a stiffer lens or any combination of the above..

[fjpod]

Perform a lid eversion. Look for clinical or even sub-clinical GPC. A lumpy tarsal conjunctiva can act like Velcro causing a lens to move excessively and/or decenter. This condition can develop over years of CL wear, or abuse. It won't disappear immediately either when the lens or habits are changed.

Check for this before going tighter. Just a thought.

[chip anderson]

Lumpy tarsal conjuntiva: Doesn't anyone know what giant papillary conjunctivitus is anymore. Isn't checking for same part of a $70.00 routine exam and all contact lens check-ups?

Gee, sho' glad one gets a "medical exam" for yo' $70.00.

Fjpod was right on but I didn't mention it because it thought it was routine.

Chip

[fjpod]

Thanks, Chip. I think that was a compliment????????

[Excel-Lentes]

Hi,


Thanks for all your input. I did lid inversion and found an unusual absence of lumpy tarsal conjunctiva (:D ) Actually that was my first suspicion and was surprised to find no GPC (LTC).

Thanks again