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Thread: Keratoconus Scleral CL patient needs eyelass lenses...help!!!

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Wave Keratoconus Scleral CL patient needs eyelass lenses...help!!!

    Calling all Guru's...

    Here's a juicy rx I'm trying to fit for a scleral contact lens wearing patient with keratoconus:

    R -15.00 -6.00 x 002
    L -11.00 -5.75 x 120

    PD OD 30.5 OS 28.5 OC 20 high
    Frame Red Paris small oval Nero Thoreau 47-22-140 small metal, no pads (especially insists on this feature) saddle bridge.

    Epidemiologist 49 year old who travels the world for work.

    Good, better, best lens options?

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    Master OptiBoarder OptiBoard Silver Supporter lensmanmd's Avatar
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    Best option. Lenticularized FF 167. Request an MR10. Assuming a 30b, I would drop the PRP by 2mm for better cosmetics.
    I bend light. That is what I do.

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Thanks!

    Is that a 30mm button? How thick is the carrier?

    OC is fit to base of pupil. Best AR? Transition available?

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    Master OptiBoarder OptiBoard Silver Supporter lensmanmd's Avatar
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    Quote Originally Posted by Uncle Fester View Post
    Thanks!

    Is that a 30mm button? How thick is the carrier?

    OC is fit to base of pupil. Best AR? Transition available?
    Soooo many questions. I personally am not set up to process lenticularized FF (yet), so I cannot answer this question. I can generate up to 30D, but can only polish up to 16D. The carrier is actually on the backside, kinda like a reverse roll. Best bet is to contact one of your lab partners for all of these questions. Epic, Luzerne, LaramieK, Premier or FEA should be able to process this, at least, those are the ones that I deal with for items that we cannot process.
    I bend light. That is what I do.

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    With Luzerne's help (thanks Jason) I've decided on a 1.74 spherical as the most practical choice.

    Still not sure if this is the final rx- waiting to talk to the doc about when the refraction was made as ideally this should be done after the final fit of his CL's and refracting an hour after wear to account for a still flattened cornea. The above rx was taken with the cornea in it's normal condition after not having worn contacts for several months.

    We'll see how this evolves.

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    Quote Originally Posted by Uncle Fester View Post
    With Luzerne's help (thanks Jason) I've decided on a 1.74 spherical as the most practical choice.

    Still not sure if this is the final rx- waiting to talk to the doc about when the refraction was made as ideally this should be done after the final fit of his CL's and refracting an hour after wear to account for a still flattened cornea. The above rx was taken with the cornea in it's normal condition after not having worn contacts for several months.

    We'll see how this evolves.

    mind sharing a pic of the finished result? would love to see it

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by Oscar View Post
    mind sharing a pic of the finished result? would love to see it
    I'm not sure when that will be as he is waiting until he gets a final CL fit and speaks to the OD who is working with him.

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    One eye sees, the other feels OptiBoard Silver Supporter
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    Quote Originally Posted by Uncle Fester View Post
    Calling all Guru's...

    Here's a juicy rx I'm trying to fit for a scleral contact lens wearing patient with keratoconus:

    R -15.00 -6.00 x 002
    L -11.00 -5.75 x 120
    A Myodisk might be the best for some folks, especially for RXs over 20 D, like this one.

    http://epiclabsinc.com/specialty-len...ndard-myodisk/

    Avoid the blended versions. Available in most materials, although I usually use CR39. Significantly improved off-axis optics compared to low Abbe full-field designs.

    Check out their other lens designs. I met the old owners about twenty years ago- they showed me a bitoric spectacle lens. Wizards they are.

    Hope this helps,

    Robert Martellaro
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



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    Why not 1.9 glass?

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by Robert_S View Post
    Why not 1.9 glass?
    Safety standards in the U.S. and an overabundance of attorney's preclude its use by any lab I am aware of.

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    Shame as it could have produced a great result.

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