Case Report: What Are We Doing for Our "20/20 Unhappy" Scleral Lens Patients?
Optom Vis Sci
; 97(9): 826-830, 2020 09.
Article
em En
| MEDLINE
| ID: mdl-32941339
ABSTRACT
SIGNIFICANCE:
Scleral lenses (SLs) partially mask higher-order aberrations (HOAs) in highly aberrated eyes. Although visual acuity (VA) may show satisfactory quantitative clinical outcomes during SL wear, residual (uncorrected) HOAs can leave subjective visual quality goals unmet.PURPOSE:
The purpose of this study was to report a case where a "20/20 unhappy" patient with SLs was able to meet visual goals with wavefront-guided SLs. CASE REPORT A 40-year-old male with bilateral keratoconus, whose Snellen VA with SLs was 20/20 right eye (OD) 20/16 left eye (OS), reported halos and glare at night and perceptual smearing. When viewing a point of light, a "Ferris wheel" shadowing was observed OD and a U-shaped shadowing OS. Residual higher-order root mean square wavefront error was 0.49 µm OD and 0.39 µm OS; visual image quality measured by visual Strehl ratio was 0.067 OD and 0.092 OS (pupil size, 4.00 mm). Wavefront-guided SLs reduced residual higher-order root mean square to 0.19 µm OD and 0.25 µm OS, VA improved to 20/10 OD and 20/13 OS, and visual Strehl improved to 0.150 OD and 0.121 OS. The patient reported reduced smearing, shadowing, and night vision concerns, meeting his visual expectations and goals.CONCLUSIONS:
Wavefront sensing quantifies both lower and HOAs, which can cause visual dissatisfaction in individuals with highly aberrated eyes, despite sometimes reaching typical levels of VA. As wavefront-guided SLs targeting these residual aberrations to improve visual image quality become more available, they should be considered for 20/20 unhappy patients when conventional clinical options are unsatisfactory.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Esclera
/
Transtornos da Visão
/
Acuidade Visual
/
Lentes de Contato
/
Aberrações de Frente de Onda da Córnea
/
Ceratocone
Limite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
Optom Vis Sci
Ano de publicação:
2020
Tipo de documento:
Article