This case report describes a 19-year-old female patient who presented with blurred vision in her right eye for distance and near vision over the past year. Examination revealed high astigmatism in her right eye and suppression in her right eye. She was fit with Purecon contact lenses in a trial, which provided ideal vision. At her dispensing visit, she was dispensed monthly replacement contact lenses in her right eye to correct her astigmatism and suppressing, along with vergence therapy exercises.

1. Case report on contact lens
correction of Astigmatism
MEENAKSHI
MOPTOM PR 003

2. Introduction
• An astigmatism is an ametropia in which light rays do not focus at a single point (American Academy
Ophthalmology, 2005) but form two focal lines.
• This image of a point is called a conoid of Sturm with two main focal or two primary meridians (Michaels D, 1988).
• If the primary meridians are always 90º apart, then it is a regular astigmatism.
• An irregular astigmatism occurs when the primary meridians are not perpendicular.
• Astigmatisms can be classified as regular or irregular based on the contribution of the ocular component and by
orientation (Benjamin W, 1998).
• Clinically, one of the most common criteria employed is with respect to the refractive error (i.e., myopia and
hyperopia).

3. Types
• Compound myopic astigmatism: both focal lines lie in front of the retina.
• Simple myopic astigmatism: one focal line is anterior to the retina, while the other one coincides with the retina (it is in focus).
• Compound hyperopic astigmatism: both focal lines lie behind the retina.
• Simple hyperopic astigmatism: one focal line is behind the retina, and the other one coincides with the retina (it is in focus).
• Mixed astigmatism: one focal line lies in front of and the other behind the retina.

4. Case discussion
• A 19years female referred to the clinic for RGP contact lens trial.
• She had complaint of blurred vision for both distance and near vision past 1 years
in the right eye.
• She had history of using Frequency Xcel toric in right eye and Biofinity toric in left
eye.
• There was no other history of eye and head trauma. Rest other history was not
contributory.

5. Investigations
• On examination, the uncorrected visual acuity measured was 6/60 in the right eye and 6/36 in the
left eye for distance.
• Visual acuity with present glasses measured was 6/9P in the right eye and 6/6 in the left eye.
• Pupillary examination revealed round pupils which reacted well to light, and RAPD was absent.
• Slit Lamp Examination revealed papillae grade I in right eye and papillae grade III in left eye, and
normal conjunctiva, clear cornea, RRR pupil in both eyes and normal clear lens in the both eyes.
• Fundus examination was found within normal limits and optic disc CDR 0.3:1 in both eyes.

6. • Current glass prescription
• OD +0.75DS/-4.75DC x 20
• OS -3.25DS/-1.50DC x 175
• SUBJECTIVE REFRACTION
• OD PLANO /-4.75DC x 30 6/9-,N6
• OS -2.75DS/-1.50 x 170 6/6, N6

7. Keratometry
• OD K1 8.05mm
• K2 7.35mm
• avg k 7.7 mm
• OS K1 8.05 mm
• K2 7.55 mm
• avg k 8.00 mm

8. • Cover test
• Distance : 30 pd exophoria
• Near : 15 pd exophoria
• NPC : 15 cm
• WFDT:
• Near normal
• RE suppression
• DIAGNOSIS
• High astigmatism in right eye
• Suppression in right eye

9. CL Trial
• OD 7.90mm/-3.00DS/10.50mm/Purecon
• Ideal fit- Reduce diameter empirically
• OS 7.80mm/-3.00DS/10.50mm/Purecon
• Ideal fit

10. Dispensing visit
• OD = 7.90mm/-0.50DS/9.40mm/2F/High
dk/ Green
• OS = 7.80mm/-3.75DS/10.50mm/2F/High
dk/ Green

11. • Vison with CL both eyes was 6/6 ; N6
• She was also prescribed Curesee for vergence therapy and Anti-
Suppression therapy.