www.kerasoft.co.uk
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HP Clinical Notes
History
At the age of 16 years HP was diagnosed with keratoconus which is now more advanced in his LE than his
RE. He is now 28 years old.
He had worn lenses since he was 18 (1999), in fact wearing the same right lens since that time. The left lens
was generally uncomfortable and had a tendancy to fall out. The hospital attempted to refit both eyes in 2007
but any improvement in fit resulted in a lower visual acuity. Lenses were worn most waking hours.
Rationale for KeraSoft® fitting
HP requested a left lens re-fit due to the problem of the RGP lens falling out along with general discomfort.
He felt he did not have any issues with the right lens, despite poor acuity and obvious photophobia. The
patient wanted to try a soft lens, even if the acuity was reduced, as he felt unbalanced if he did not wear any
lens in his LE.
Initial Findings
No details of RGP lenses being worn was available, and HP had no spectacles.
Acuity with RGP lenses:
RE: 6/12 +2.00 over refraction VA 6/12 LE: 6/19 No over refraction improves acuity
Spectacle Refraction
RE: Vision 6/19 no improvement LE: <6/60 Plano/-20.00 x 100 6/60 just
Topography Keratoscopy – No Mapping Possible
RE LE
Slit Lamp
HP was very photophobic in both eyes and there was significant central scarring on both corneas consistent
with heavy central bearing RGP contact lenses. In fact the left cornea demonstrated a double scar
representing the areas where the lens came to rest. Both corneas showed central punctuate staining in the
scarred areas.
UltraVision International Ltd, Commerce Way, Leighton Buzzard, Beds, LU7 4RW
UK Freephone 0800 585115 or +44 (0)1525 381112
email: info@ultravision.co.uk web: www.ultravisiongroup.com
®
HP Clinical Notes Cont’d
LE Scarring
Management
As the corneal surface was extremely distorted, HP was asked to reduce RGP wear in the LE before fitting
was attempted. He reduced wear over the next few weeks until he managed to leave the lens out for most of
the day, only wearing it for driving.
2 month follow up
The left cornea was now settled and the scarring had started to resolve.
Topography/Simulated Keratometry Readings
LE Topography LE Keratoscopy
KeraSoft® IC SMC Fitting
LE: 8.80/15.00/FLT2/STP2/-11.75/-5.50 x 141 A1: 30 / A2: 150 / A3: 220 / A4: 320 VA 6/8-
1 Month Follow Up
HP reported the Left lens was comfortable and he had experienced a reduction in light sensitivity but had
difficulties with his eyes “pulling”. He had also been wearing the right lens longer recently due to work
commitments and felt his lid had become swollen.
UltraVision International Ltd, Commerce Way, Leighton Buzzard, Beds, LU7 4RW
UK Freephone 0800 585115 or +44 (0)1525 381112
email: info@ultravision.co.uk web: www.ultravisiongroup.com
®
HP Clinical Notes Cont’d
Refraction
RE: +5.50 over refraction on RGP VA 6/12 LE: No over refraction VA 6/8
Slit Lamp
RE: RGP lens was fairly immobile and the density of central scar had increased.
Management
The pulling sensation was caused by increased accommodative effort due to focusing through the extra
minus on the right lens. This lens was now unsuitable, however as HP is RE dominant, he was unable to leave
the right lens out to let the cornea settle by managing with left vision only. Therefore, a KeraSoft® IC was fitted
to the RE without any prior corneal settling time.
KeraSoft® IC SiH (SMC)
RE: 8.40/15.00/FLT1/STP2/-1.50/-5.25 x 50 VA 6/8
A1: 30 / A2: 150 / A3: 220 / A4: 320
HP was warned that vision in the RE with the KeraSoft® IC would vary as the cornea settled down during the
post RGP demoulding phases.
Summary
HP had reached a point where his vision with RGPs was no longer acceptable and no improvements could
be made. He was suffering with photophobia and had significant corneal scarring.
Initially the LE was refitted with KeraSoft® IC. Based on the comfort of this lens HP decided to be refitted with
KeraSoft® IC in his RE as opposed to an RGP as he had originally planned. This fitting process is still in
progress and the current lenses are:
KeraSoft® IC SiH (SMC)
RE: 8.40/15.00/FLT1/STP2/-1.50/-5.25 x 50 VA 6/8
A1: 30 / A2: 150 / A3: 220 / A4: 320
LE: 8.80/15.00/FLT2/STP2/-11.75/-5.50 x 141
A1: 30 / A2: 150 / A3: 220 / A4: 320 VA 6/8-
UltraVision International Ltd, Commerce Way, Leighton Buzzard, Beds, LU7 4RW
UK Freephone 0800 585115 or +44 (0)1525 381112
email: info@ultravision.co.uk web: www.ultravisiongroup.com