Precision Fit Success for a Highly Toric Sclera

Courtesy of Dr. Brayden Lundquist, OD, FAAO, FSLS, West Valley Vision Center, Goodyear, AZ

Presentation: Toric soft contact lens wearer with a history of contact lens instability and inconsistent vision during lens wear.

Spectacle Rx:

OD: +4.50-6.25×133
OS: +4.75-6.00×043

A large amount of oblique corneal astigmatism (see Pentacam images) as well as lenticular astigmatism made corneal RGP and hybrid contact lens designs less than ideal to provide comfortable and clear vision for this patient.

During a diagnostic fitting with a quadrant specific scleral lens, an extremely poor haptic fit with multiple designs and diameters was noted. A Pentacam corneo-scleral profile was obtained and revealed a highly toric sclera. A Gaudi QS lens with front toric optics was designed to match the corneal-scleral toricity and provided a comfortable and stable lens for insertion and removal training as well as subsequent lens habituation for this first time scleral lens wearer. Minor adjustments to haptics and over-refraction were made thereafter.

The Gaudi QS design provided a precise fitting option for this patient that would have required significant adjustments to standard quadrant specific diagnostic lens designs and provided clear, stable, and comfortable vision in a contact lens for this patient.

Gaudi dashboard for scleral lens design OD flat and steep meridians

Gaudi dashboard for scleral lens design OS flat and steep meridians

Corneo Scleral Elevation Maps OD – OS

Axial Maps OD

Axial Maps OS

Dr. Lundquist has received no remuneration from EYEXY, including for the writing of this article.