Office Talk: Scleral Patients Update - E28
Today we are talking about scleral lenses. I fit 5 patients about a month ago, had their dispensing appointments, and now they have had their 2 week follow-ups. It was really successful. 3 patients were absolute home runs. Had it not been for me forgetting that trial lenses have power and merely ordering the over-refraction without factoring in the lens power, we would have been done after one lens! The patients were happy and doing well.
The other 2 patients were good learning experiences. The first was a 36 you male. He has mild keratoconus OU and sees ok with glasses. His motivation is quite low and as I have learned the 18-40 year old males can be some of the hardest to fit for this reason alone. The fit was fine, but he was really picky about his vision, even though he was reading much better than his glasses. I made small changes to Rx and will see how he fares with more time to practice I and R and adapt to the new Rx.
The second had some mid-day fogging and front surface wetting issues. There was a lot of protein buildup on the front of the lens. I did the touch test and realized the fluorescein was entering in the steep meridian. I tightened the steep meridians in both eyes, added hydra-peg to both lenses, and I am having the patient use boston original conditioning solution on insertion.
I am definitely loving fitting sclerals, now I just have to figure out how to recruit more patients! Tune in next week for more updates!
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