what material would you use?

**Ecliptic** · 06-30-2008, 04:26 PM

patient has moderate levels of keratoconus, RX:

OD -4.50 -3.00 x 035
OS -5.00 -0.50 x 180

what material would you use to maximize his vision in glasses?

high index 1.67?
trivex?

<3

**Andrew Weiss** · 06-30-2008, 04:31 PM

Probably 1.6, even though it isn't as strong a material as 1.67 or trivex. The visual clarity will be better than 1.67 and the lens will be thinner than trivex.

**chip anderson** · 06-30-2008, 04:52 PM

:bbg:Maximixeing vision in keratoconnus with spectacles isn't possible. Fit the patient with rigid contacts or send him to someone who can.

Chip

**Ecliptic** · 06-30-2008, 04:55 PM

he is being fit in rgps... but as a back-up and to use when he isn't using contacts what would be optimal for him?

**chip anderson** · 06-30-2008, 05:14 PM

Doesn't matter except from the standpoint of thickness. If he's a cone he is only going to wear them to find his contact lenses with in the morning and the bathroom at night. So cosmetics shouldn't be too big a deal.
Once he finds out how lousy the spectacle vision is to the contacts that's all he will use the glasses for.
I also highly advise all patients with high corrections, specialized designs, etc. to get a spair pair of contact lenses once the final fit and Rx have been arrived at. These people are pretty unhappy while waiting for replacements to arrive. Some are even incapacitated.

Chip

**Jacqui** · 06-30-2008, 05:43 PM

Ditto what Chip said.

**sharonm516** · 06-30-2008, 09:47 PM

Originally Posted by chip anderson

Doesn't matter except from the standpoint of thickness. If he's a cone he is only going to wear them to find his contact lenses with in the morning and the bathroom at night. So cosmetics shouldn't be too big a deal.
Once he finds out how lousy the spectacle vision is to the contacts that's all he will use the glasses for.
I also highly advise all patients with high corrections, specialized designs, etc. to get a spair pair of contact lenses once the final fit and Rx have been arrived at. These people are pretty unhappy while waiting for replacements to arrive. Some are even incapacitated.

Chip

Ditto!

**MarcE** · 06-30-2008, 10:40 PM

I would take Chip's advice first and then recommend 1.60 for specs.
If cost is an issue, especially after recommending the spair pair of CL, then 1.56 (this lens is stock form is inexpensive).
I am a big user of poly, but high cyls are where we have problems w/ poly. That's why I would recommend 1.60, but not if it impeded the patient's ability to afford a spare pair of CLs