Transcript to case information in PowerPoint.

Synergeyes case 1
Derek Louie
• 35 y.o male presented 2009 for gradual progressive
blur @ distance OD>OS x 5 years. Wears reading
glasses to help @ near, but getting worse.
VAs
SC
Near sc
PH
Right eye
20/200
/
/
/
20/40
Left eye
20/30 /
/
/
20/20
OU
Current glasses none
• Manifest here:
Manifest
sphere
cylinder
axis Visual
acuity
Right eye
-2.00 -3.50 011 20/60
Left eye
-0.25 -1.00 111 20/20
Near add
//+1.25
/,/
• Exam findings:
– Cornea OD – fleisher’s ring 1+ straie, no scarring
– Cornea OS – clear
– All other findings WNL
• Humphery atlas ordered.
• Keratoconus Dx, OD>>OS – see topography
• Fit last year with Synergeyes A lens, good
correction OD only.
• Final lens: Synergeyes A/ 7.1 (8.4 skirt)/ 2.75/14.5 ---20/25
• Did well, returns this year with no problems for
annual medical exam
Humphery topography 7/2009
Returned for annual exam 10/2010
• No problems with vision, good comfort of
lens, vision seems stable.
• 20/30 OD (thru hybrid lens)
• 20/25 OS (uncorrected)
• Cornea OD
– 1+ punctate staining central inferior, no scarring
– All other findings WNL
• Plan: Refit OD with steeper BC/different lens
design
•
•
Initial Dx lens: Clearkone 250 vault/-4.50/14.5/ medium skirt
Clearance central and light feather touch in ILZ, good movement
• +3.50 Over-refraction of diagnostic lens =
20/30 vision
• Likely may improve when SPK/PEE resolves
• RTC 2 weeks for contact lens/cornea check
• Decreased Vault: ClearKone 200 vault/-3.00/14.5/ medium skirt,
• Good movement (0.25 MOB) but too much touch central and in ILZ
Synergeyes Case 2 (if needed)
• 8 year old female with h/o traumatic corneal
laceration due to stabbing herself in the right eye
with a small knife when she was 3 y.o.
• Wore aphakic CL for several years, recently had
sewn in IOL and pupilloplasty
• Best corrected vision with spectacles (+5.006.00x010) 20/100, ph 20/80
– OS 20/20 sc
• Started with synergeyes A/7.9/-3.00/14.5
+2.50 OR = 20/80 distance VA, 20/400 near
• Ordered in slightly steeper b/c to improve fit,
and considered multifocal option for near VA
Final CL Rx:
Synergeyes M /7.8 BC /-1.00,+2.25 add (2.2 seg size) /8.8 skirt/14.5
20/80 (ph20/70) with 20/60 near
No improvement with over-refraction @ distance or near
Referred for VT/ambylopia tx.