Contact lens management of keratoconus.

Contact lenses are the primary form of visual correction for patients with keratoconus. Contemporary advances in contact lens designs and materials have significantly expanded the available fitting options for patients with corneal ectasia. Furthermore, imaging technology, such as corneal topography and anterior segment optical coherence tomography, can be applied to both gain insight into corneal microstructural changes and to guide contact lens fitting.

Replication and meta-analysis of candidate loci identified variation at RAB3GAP1 associated with keratoconus.

Purpose: Keratoconus is a common complex corneal ectasia that can lead to severe visual impairment. Although a genetic component is well recognized, the genetic risk factors for keratoconus are yet to be fully elucidated. A recent genome-wide association study (GWAS) by Li et al.

Contact lens management of keratoconus in a patient with residual astigmatism resulting from implantation of a toric intraocular lens.

Toric intraocular lenses (IOLs) are increasingly being used at the time of cataract surgery to treat regular refractive astigmatism. This paper outlines the contact lens management of a patient with keratoconus, who had marked residual astigmatism post-operatively due to implantation of a toric IOL during cataract surgery. It is strongly recommended that toric IOLs should only be prescribed for patients who have mild forms of keratoconus, with only slight irregular astigmatism that has been stable for at least the previous 12 months and acceptable vision with spectacles.

Contact lens management of infantile aphakia.

The visual outcomes for infants 18 months or younger with cataracts have improved dramatically over the past couple of decades. Earlier detection of infantile cataract and prompt surgical removal-with subsequent visual rehabilitation with contact lenses-mean that these patients now have a much better visual prognosis. Advances in contact lens technology have led to a significantly higher success rate with contact lenses and this has been a major factor in improving the visual outcomes for aphakic infants.

A randomized controlled trial of corneal collagen cross-linking in progressive keratoconus: preliminary results.

Purpose: This prospective, randomized, controlled trial aims to provide evidence in relation to the efficacy and safety of corneal collagen cross-linking (CXL) in the management of progressive keratoconus.

Methods: Eligible eyes were separately randomized into either treatment or control groups. Collagen crosslinking was performed using 0.

Acanthamoeba keratitis and contact lens wear.

Acanthamoeba keratitis is a rare but serious complication of contact lens wear that may cause severe visual loss. The clinical picture is usually characterised by severe pain, sometimes disproportionate to the signs, with an early superficial keratitis that is often misdiagnosed as herpes simplex virus (HSV) keratitis. Advanced stages of the infection are usually characterised by central corneal epithelial loss and marked stromal opacification with subsequent loss of vision.

A bitoric rigid contact lens with base down prism to eliminate binocular vertical diplopia.

Prism base down can be incorporated into a rigid gas permeable contact lens to align the diplopic images in a patient who has a significant vertical phoria. A rigid lens may also incorporate both vertical base down prism and a toroidal back surface - the vertical prism to correct the heterophoria and the toric back surface to improve the physical fit of the lens on a highly toric cornea. This paper presents a case where vertical diplopia due to a post-surgical left hyperphoria of about four prism dioptres was eliminated by the incorporation of the appropriate amount of base down vertical prism into a bitoric rigid gas permeable contact lens.

Contact lens fitting following corneal graft surgery.

Contact lens fitting may be required following keratoplasty for either optical or therapeutic reasons. Optical indications for contact lens fitting include the correction of irregular astigmatism, high regular astigmatism, anisometropia and secondary aniseikonia, as well as simple ametropia, where the patient desires to wear contact lenses in preference to spectacles. Therapeutic lenses are not routinely fitted following keratoplasty, although this management is advised in certain cases, such as when there are protruding sutures or epithelial healing is impaired.

Pterygium-induced corneal astigmatism.

A significant degree of corneal astigmatism can be induced by the encroachment of a pterygium onto a cornea. The pterygium generally causes with-the-rule corneal astigmatism that is hemimeridional on the side of the pterygium. There is a significant correlation between the extension of the pterygium onto the cornea and the amount of induced astigmatism.