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Management of achromatopsia. Prescribe or not: A case report

This case report explores the use of tinted contact lenses in the management of achromatopsia, a congenital visual disorder characterized by reduced cone function. The report discusses the clinical characteristics and case history of a 34-year-old accountant diagnosed with achromatopsia and highlights the use of tinted contact lenses to alleviate symptoms such as photophobia. The study concludes that tinted contact lenses can provide visual comfort for patients with achromatopsia, even with minimal improvement in visual acuity.

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Management of achromatopsia. Prescribe or not: A case report

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  1. Management of achromatopsia. Prescribe or not: A case report Presented by K.M. Law, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China

  2. Background • Achromatopsia is a congenital, inherited visual disorder in which cone function is either absent or reduced.

  3. Clinical characteristics of achromatopsia • Reduce VA • Photophobia • Significant refractive error • Reduce or complete loss of colour discrimination

  4. Case history • A 34-year-old accountant diagnosed of achromatopsia since childhood. • Subjective refraction OD: -13.00 DS (VA: 10/100-) OS: -14.50 / -1.50 X 180 (VA: 10/100-) • Abnormal colour vision • Reduced contrast sensitivity • Corning 527X filter was used to reduce light sensitivity currently

  5. OD OS Fundus

  6. Contact lens fitting

  7. Contact lenses OD with prosthetic red lens OS with clear lens

  8. Discussions • Photophobia is a common complain of people suffered from achromatopsia. • Symptoms of photophobia in patients with achromatopsia may be relieved due to attenuate light reaching the retina with the use of tinted contact lens. • Tinted contact lens may provide better visual comfort than tinted spectacle as it could limit periphery glare, eliminate back surface reflections and align visual axis better than spectacles.1

  9. Conclusions • Tinted contact lenses should be considered if patient found significant improvement in visual comfort even though the improvement of visual acuity was minimal clinically. • Tinted zone of contact lenses should cover and well beyond the pupil margin under dim and bright conditions. • Extra care should be needed to minimize contact lens complications.

  10. Reference • Red contact lenses for alleviation of photophobia in patients with cone disorders. Park WL. Sunness JS. American Journal of Ophthalmology. 137(4):774-5, 2004 Apr.

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