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THE CUSTOM STABLE AURORA
BRINGS BACK THE COMFORT |
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Derek Louie, MSc, OD, FAAO
Clinical Associate Professor, Ophthalmology
Casey Eye Institute
Oregon Health & Science University |
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| June 1, 2016 |
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CASE REPORT
A fifty-eight year old presented for re-evaluation of multifocal contact lenses. She had
been previously successfully wearing translating bitoric multifocal GP lenses. As an
anesthesiologist, these lenses were causing decreased comfort, intermittent dryness
and intermittent blur due to her very specific visual tasks.
Multifocal soft toric lenses were attempted without success.
She currently wears her progressive addition lenses for work but finds these may also
cause blur depending on the operating room set up.
Her past ocular history was unremarkable for other eye conditions. No previous injury
or significant ocular or systemic disease in either eye. All ocular findings were unremarkable
including dilated fundus exam. |
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| REFRACTIVE ERROR |
| +1.25-2.50x002 |
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20/20 (dominant eye) |
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| Add: +2.00 |
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KERATOMETRY READINGS
47.60/45.20 @ 170
49.20/45.5 @ 013 |
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PLAN
Custom Stable Aurora multifocal lenses were recommended as an evolutionary step, to
address her task specific focal distances, symptoms of dryness and increase stability of
her visual correction.
Lenses were selected based on diagnostic fit from a Custom Stable Elite 14.8 fitting set
and over-refraction. |
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| INITIAL LENS ORDER: |
| RE: |
Aurora (dominant)
BC: 7.85
Rx:+3.50/+2.00 add
OAD: 14.8 LCZ: 0.5 flat
SLZ: +4/0
Material: Optimum Extra
Tint: clear |
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| LE: |
Aurora
BC: 7.67
Rx:+3.25/+2.25 add
OAD: 14.8 LCZ: 0.5 flat
SLZ: +8/0
Material: Optimum Extra
Tint: Blue |
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The patient was able to apply and remove scleral lenses and reported excellent initial
comfort at dispense. VA was 20/20-2 and 20/40 (OS), 20/25 and 20/20 (OS) near. The
patient was instructed to practice application and removal and wear lenses regularly for
2 weeks before re-evaluation.
At follow up visit, the patient reported no problems with application and removal along
with excellent comfort overall with mild edge awareness left eye. The patient also
reported blur at distance left eye that was bothersome. |
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ON EVALUATION: (4 hours of wear reported):
RE: 100 microns clearance over central cornea, clearance over limbus, toric markings
at 3/9 with good apposition to sclera 360. +/-0.50 no improvement in VA
20/20- distance, 20/25 near
LE: 150 microns clearance over central cornea, clearance over limbus, toric markings
at 3/9 with moderate edge lift along flat meridian temporal>nasal. -1.00 OR improves
distance to 20/25-2, 20/25 near.
20/20- distance, 20/25 near
With OR OS:
20/20 OU
20/25 near, comfortable intermediate VA @ habitual computer monitor
A second left lens was ordered, no changes to the right lens was indicated: |
| LE: |
Aurora
BC: 7.67
Rx:+2.50/+2.25 add
OAD: 14.8 LCZ: 1 flat
SLZ: +6/0
Material: Optimum Extra
Tint: Blue |
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ADDITIONAL COMMENTS
The patient reported excellent comfort, good vision at most distances during the day,
and was asked to return in 1 year for annual eye health and vision examination or
sooner if symptoms arise. |
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