The document summarizes a case study of a 20-year-old male patient with left eye vision loss since childhood due to corneal scarring who was fitted for a prosthetic soft contact lens. Details are provided on the patient's history and examination, differential diagnosis, types and fitting criteria of prosthetic contact lenses, fitting of a medium brown type D prosthetic lens, and fitting assessment showing good coverage, centration, and movement. The plan is for the patient to be fitted with a single purecon prosthetic soft contact lens.
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Scleral lens is a large rigid contact lens with a diameter range of 15mm to 25mm. Its resting point is beyond the
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This presentation include what are the pre-assessment required for fitting Contact lens in children and process of insertion and removal with a small knowledge about different lens that we can use for pediatric Contact lens
direct ophthalmoscope
fundoscopy course
fundus examination
medical students
ophthalmology
faculty of medicine
kafrelsheikh university
new mansoura university
delta university
Contact lens for congenital aphakia and other eye conditions for infants and toddlers. The slide presentation encompasses indications for CL fitting in paediatric, contact lens options, fitting techniques, challenges and contact lens as myopia control.
Scleral lens is a large rigid contact lens with a diameter range of 15mm to 25mm. Its resting point is beyond the
corneal borders, and are believed to be among the best vision correction options for irregular corneas. Wearing scleral lens also can postpone or even prevent surgical intervention as well as decrease the risk of corneal scarring.
This presentation include what are the pre-assessment required for fitting Contact lens in children and process of insertion and removal with a small knowledge about different lens that we can use for pediatric Contact lens
direct ophthalmoscope
fundoscopy course
fundus examination
medical students
ophthalmology
faculty of medicine
kafrelsheikh university
new mansoura university
delta university
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http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
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Prosthetic Contact Lens (Grand round)
1. Presenter: Pooja Sah (Optometry Intern)
Moderator: Suraj Chaurasiya (Consultant Optometrist)
Date : 25/04/2019
C L Gupta eye institute , Moradabad
Grand Round
1
2. Complain and history
• A 20 years / Male patient was visited to the hospital on
06/04/2019 with the complaint of left eye loss of vision for
distance and near since childhood followed by chicken pox
• Ophthalmic consultation with Dr. Salman 3 days prior where
advised for corneal tatooting or corneal prosthesis and
referred to CLGEI
• Other history: not significant
2
3. RIGHT EYE LEFT EYE
UCVA- Distance
Near
20/20
6/6 at 33cm with reduce
snellen E chart under RI
HM+
<6/60 33cm with reduce
snellen E chart under RI
Dry retinoscopy -0.50*90 No glow
Acceptance Plano (20/20) HM+
Visual acuity assessment
3
4. 4
Right eye Left eye
Eyelid Flat Trichiatic lashes
conjunctiva Normal Conjunctival xerosis
sclera Normal Normal
cornea clear Corneal xerosis, scaring
AC Normal in contents and Depth
PACD=1CD
No view
Iris Normal color and pattern No view
Pupil Round , Regular, Reacting No view
IOP (GAT) 16 mm of Hg @ 10:45 am Dig N
Slit lamp examination
6. Introduction
• A prosthetic contact lens (artificial iris) is a contact lens used
on both sighted and non-sighted eyes to improve their
cosmetic appearance
6
7. Types and indications of prosthetic CL
• Amblyopia
therapy
• Cataract
• Traumatic
Mydriatics pupil
• Iris coloboma
• Aniridia
• Heterochromia
• Microphthalmus
• Albinism
• Corneal scars/
opacities
• Failed graft
Type A Type B Type C Type D
Occlusion Therapy
7
8. Fitting criteria
Record the following:
• Pupil size (normal room illumination)
• Iris Diameter (i.e 11.5mm)
• Base Curve
• Diameter
• Color Matching
Color available :
• Light brown
• Medium brown
• Dark brown
IACLE Module 9; chapter prosthetic contact lens 8
9. Student corner
• What is the fitting assessment for Prosthetic soft contact lens?
• Coverage
• Centration
• Movement
• Tightness
• Lag
• Fluting
9
IACLE module 3
10. CL clinic
Base curve Power Diameter Remarks
Median 0.00 14.00 Prosthetic contact lens
Type D medium brown
Iris: 11.80mm
Pupil: 4.50
clear periphery: 1.10
Fitting assessment
Coverage 360 limbal coverage
Movement 0.20 mm
Tightness 60%
Impression Acceptable
Centration No decentred
Lag Up Gaze lag 0.1 mm
Fluting Absent
Inserted parameter:
10
11. 11
Final parameters:
Same as inserted parameters
Plan of management:
Single Purecon Prosthetic soft contact lens was ordered
12. Learning objective
• Differential diagnosis of corneal scar
• Classification of prosthetic soft contact lens
• Indications of different types of prosthetic soft contact lens
• Fitting criteria of the prosthetic contact lens
• Fitting assessment of the soft contact lens
Faculty corner
Do you want to add anything extra related to prosthetic CL
fitting?
12
Editor's Notes
Xerosis?
Put pic of all types of scarring?/
TYPE A –pupil only tinted , iris are clear
TYPE B/O- whose lens tinted ,no separate pupil
TYPE C - iris are tinted ,clear pupil
TYPE D-iris are tinted ,pupil tinted separately
In a normal room illumination the average pupil size is 4.5mm
Iris dia is important to measure to ensure total coverage of any noticible disfigurement (measure from a healthy ey, if possible
Many Patients have an intact cornea where proper K readings can be recorded. However, patients with disfigured, scarred corneas can be quite difficult to measure. In this type of case, we can start with initial 8.60 BC
The most difficult measurement in fitting a prosthetic soft lens is color matching
Coverage: Mainly we need to see whether the lens is covering the whole cornea or not
Centration: Bynasal system (X: +N, -T; Y: +S, -I)
Movement (0.2 to 0.8mm)
Upgaze lag (up to 1.5 mm acceptable)
Tightness: Asked the pt to look straight and with the help to lower lid margin push the lens up, so how much pressure is applying to push the lens is tightness
Clear periphery how to calculate???
BC: median??? find out in number??
