Case Studies
Terrien’s Marginal Degeneration, Mr ML, Sep 2022
Mr ML came to see me for a contact lens fitting following a diagnosis of Terrien’s Marginal Degeneration. He had been suffering with progressively worsening poor vision in the RE for a few months, and subsequently saw a consultant ophthalmologist who diagnosed him and advised him that his best option for vision correction would be contact lens fitting.
Mr ML’s best corrected VA in the RE was 6/60, improving to 6/15 with pinhole. His refraction revealed a 20 dioptre cylindrical component in the RE (not genuine astigmatism) which was being caused by the thinning at the temporal limbus.
I advised Mr ML that the best course of action would be to try a mini scleral lens as it would vault over the cornea, mask the induced astigmatism, and give him great vision and comfort.
I fitted him with the following lens:
Bausch and Lomb Zens Lens Oblate
9.00/16.00+6.50
Sag 4600
LCC +100
Post LASIK Ectasia, Mr AG, Oct 2021
A good friend and old colleague of mine came to see me as he had been having some problems with his RE for the past 3 years, and it had been getting progressively worse. He had had refractive surgery in 2010 and thought his myopia was now beginning to regress.
His examination revealed reduced vision and a very large amount of astigmatism. His scans (image on the left) showed steepening of the inferior cornea as well as corneal thinning.
His prescription in the RE was:
+3.50/-4.75 x 155 VA 6/15
Suspecting Post LASIK Ectasia, I referred him to a corneal consultant for confirmation of diagnosis (it was confirmed), followed by corneal cross linking to stabilise the cornea. Following his treatment, he returned to me for a contact lens fitting. Given the low nature of the corneal steepening, I fitted him with a large diameter RGP lens:
Rose K2 IC Optimum Comfort
7.20/10.40/-2.00
EL +1, ACT grade 1
6/6
He successfully wears the lens everyday with great comfort and has wonderful vision.