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custom stable™ | SPOTLIGHT
 
 
 
 
CASE STUDIES, TIPS & RESOURCES – MAY 2016 EDITION
 
 
 
 
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PILOT’S VISION TAKES FLIGHT   Josh Adams
 
THE CUSTOM STABLE ELITE RESTORES THE
VISION OF A GROUNDED PILOT
 
Roya Habibi, OD, FAAO
Eye Associates NW, PC
Seattle, WA
 
May 15, 2016
 
CASE REPORT
70 year old male patient presented to clinic for a referral from a corneal specialist after ruling out cataracts as main cause of decreased visual acuity. The patient is a commercial pilot and wasn’t meeting the FAA guidelines for BCVA. He has no complaints of dryness, eye pain or fluctuating vision. The patient had previously tried corneal gas permeable lenses, which seemed to have improved the vision, but the instability of vision, watering eyes, and potential for ejection led him to be uncomfortable with that option.
 
GOALS
His goals were strict: he needed to be able to see 20/20 at all distances (distance, intermediate and near locations) in both eyes, though he had the option of spectacles, contacts or both. He needed the vision to be stable and reliable due to the responsibility of flying. He also wants to put off cataract surgery (unless it is the true cause of visual blur) due to required time off from flying.
 
BCVA WITH SPECTACLES
OD: -1.50-1.25x100 20/25-2
OS: -2.00-1.00x085 20/25
 
KERATOMETRY READINGS
OD: 42.12 / 42.75 x 175; irregular mires
OS: 42.50 / 44.00 x 175; irregular mires
 
OD | SIMK:42.57@148/41.86@58 MINK:41.86@86
 
OS | SIMK:43.14@37/42.64@127 MINK:42.63@104
 
EXAMINATION FINDINGS
OD: wavy lines throughout cornea 2+, no staining with fluorescein; 1+ cortical spoking, 2+ nuclear sclerosis; posterior segment unremarkable

OS: wavy lines throughout cornea 3+, no staining with fluorescein; 1+ cortical spoking, 2+ nuclear sclerosis; posterior segment unremarkable
 
 
Figure 1: OS after 1 month of scleral lens wear
 
PLAN
A contact lens over-refraction found that the vision improved significantly with gas permeable contact lenses. The patient was fit in scleral contact lenses to provide the most stable vision. It would also provide a liquid barrier to the cornea that is evident for epithelial basement membrane dystrophy (EBMD) (see Figure 1). Though he was not yet symptomatic, this would theoretically provide the cornea with less stress through the day with the protection of the cornea from constant friction from the eyelids.
 
BCVA WITH SCLERAL CONTACT LENSES + SPECTACLES
OD: Custom Stable Elite 41.00bc / 15.8 diam / -3.75 sph / std LCZ / +3/0 Toric SLZ
VA 20/20
        Spec over correction: plano -0.50 x 069 +2.50 Add / DVA: 20/15 / NVA 0.4/0.4M
OS: Custom Stable Elite 42.00bc / 15.8 diam / -3.00 sph / std LCZ / +3/0 Toric SLZ
VA 20/15-2
        Spec over correction: plano +2.50 Add / DVA: 20/15 / NVA 0.4/0.4M
 
ADDITIONAL COMMENTS
EBMD is caused by faulty basement membrane formation of the corneal epithelium and can result in blurred vision, recurrent epithelial erosions, glare; though many patients are asymptomatic. This patient was ecstatic with our plan and final treatment for his eyes. He was able to maintain his current aviation license without undergoing a procedure that was not yet necessary for him. The procedure could have also destabilized his corneas further, leading to more irregularity and decrease in vision. He is now able to wear his lenses comfortable (without feeling like anything is in) for over 15 hours per day.
 
 
 
 
 
custom stable ™
 
The Custom Stable™ is a life changing scleral lens that can transform your practice. It fits easy, has exceptional visual acuity and provides all day comfort. With its ability to vault the cornea and create a natural tear lens the Custom Stable™ is a great fit for regular and irregular corneas that need the best in comfort and performance. Contact Valley Contax today to get started. Contact Valley Contax today to get started.
 
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OPTIMUM  byCONTAMAC
 
For superior performance and comfort Valley Contax recommends Optimum GP materials by Contamac for the Custom Stable line of lenses.
 
 
 
 
 
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  Want to learn to fit the Custom Stable lens? It’s easy, just visit our website and take the Custom Stable Training Course. It’s free, just watch the 17 minute video and complete the quiz. You’ll receive a certificate of completion and a coupon once you’ve passed.  
 
 
 
About Valley Contax
 
Valley Contax is the world’s leading independent custom contact lens manufacturer. Since 1981 we’ve built a reputation and following for exceptional products and customer service. From our state-of-the-art facilities in Springfield, Oregon we staff the industry’s most talented lab technicians, customer care representatives and consultants. Contact us today, we’d love to get to know you.
 
 
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Want to hit the fast track to learning how to fit the Custom Stable™? Join us for one of our Custom Stable Friday sessions. This is a hands-on approach to learning everything you need to know about fitting, application and removal at our state of the art facilities in Springfield, Oregon. Check our website or contact us for available dates and more info.
 
 
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