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Synergeyes case 1

Synergeyes case 1. Derek Louie. 35 y.o male presented 2009 for gradual progressive blur @ distance OD>OS x 5 years. Wears reading glasses to help @ near, but getting worse. VAs SC Near sc PH Right eye 20/200 / / / 20/40 Left eye 20/30 / / / 20/20 OU

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Synergeyes case 1

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  1. Synergeyes case 1 Derek Louie

  2. 35 y.o male presented 2009 for gradual progressive blur @ distance OD>OS x 5 years. Wears reading glasses to help @ near, but getting worse. VAs SC Near sc PH Right eye 20/200 / / / 20/40 Left eye 20/30 / / / 20/20 OU Current glasses none • Manifest here: Manifest sphere cylinder axis Visual acuity Right eye -2.00 -3.50 011 20/60 Left eye -0.25 -1.00 111 20/20 Near add //+1.25 /,/

  3. Exam findings: • Cornea OD – fleisher’s ring 1+ straie, no scarring • Cornea OS – clear • All other findings WNL • Humphery atlas ordered. • Keratoconus Dx, OD>>OS – see topography • Fit last year with Synergeyes A lens, good correction OD only. • Final lens: Synergeyes A/ 7.1 (8.4 skirt)/ -2.75/14.5 ---20/25 • Did well, returns this year with no problems for annual medical exam

  4. Humphery topography 7/2009

  5. Returned for annual exam 10/2010 • No problems with vision, good comfort of lens, vision seems stable. • 20/30 OD (thru hybrid lens) • 20/25 OS (uncorrected) • Cornea OD • 1+ punctate staining central inferior, no scarring • All other findings WNL • Plan: Refit OD with steeper BC/different lens design

  6. Initial Dx lens: Clearkone 250 vault/-4.50/14.5/ medium skirt • Clearance central and light feather touch in ILZ, good movement

  7. +3.50 Over-refraction of diagnostic lens = 20/30 vision • Likely may improve when SPK/PEE resolves • RTC 2 weeks for contact lens/cornea check

  8. Decreased Vault: ClearKone 200 vault/-3.00/14.5/ medium skirt, • Good movement (0.25 MOB) but too much touch central and in ILZ

  9. Synergeyes Case 2 (if needed) • 8 year old female with h/o traumatic corneal laceration due to stabbing herself in the right eye with a small knife when she was 3 y.o. • Wore aphakic CL for several years, recently had sewn in IOL and pupilloplasty • Best corrected vision with spectacles (+5.00-6.00x010) 20/100, ph 20/80 • OS 20/20 sc

  10. Started with synergeyes A/7.9/-3.00/14.5 +2.50 OR = 20/80 distance VA, 20/400 near • Ordered in slightly steeper b/c to improve fit, and considered multifocal option for near VA

  11. Final CL Rx: Synergeyes M /7.8 BC /-1.00,+2.25 add (2.2 seg size) /8.8 skirt/14.5 20/80 (ph20/70) with 20/60 near No improvement with over-refraction @ distance or near Referred for VT/ambylopia tx.

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