When the practitioner says there is a bubble present, it would be best if the consultant could see the bubble. In this case the lens isn’t too steep, but it is fixing itself onto the steep portion of the cornea that has pellucid marginal degeneration, and the lens is tilted causing what is known as “Z” axis tilt, thus an air bubble forms. The photo was taken through the slit lamp oculars.
If the practitioner taking the pictures isn’t quite comfortable taking the pictures through the slit lamp, then there is nothing wrong with using the cell phone camera outside the slit lamp to take the picture. This will still give valuable fitting hints based on what is seen.
Then the practitioner asks the consultant if a change may be needed on a GP fit on this corneal graft that has a 10 diopter variance from the flattest point to the steepest point in the grafted portion of the cornea. The photo shows a reverse geometry design in a large diameter GP Lens on the grafted eye. What do you think…. leave it as is or adjust it?
Sometimes using the tools we already have is the answer. The quality of the pictures and what has taken place with the cell phone technology of today is right at our fingertips. Videos and still pictures are much better than words used for describing GP lens fits. Use what is already available for much better results!
Maybe the practitioner tells the consultant the lens seems a little on the loose side, so just steepen the fit a little bit. How much is “a little loose”? The amount of fit change can better be determined looking at the picture sent as shown here. This is a reverse geometry lens on an irregular cornea that should be steepened no less than 1.00D and the PC’s steepened as well.
EyEWitnEss spring 2011
c o n ta c t l e n s s o c i e t y o f a m e r i c a
w w w. c l s a . i n f o
Table of Contents for the Digital Edition of CLSA Eye Witness Spring 2011