DM came back in for a 2 day post treatment and see’s 20/20 at 10AM in the right eye and 20/40 in the left eye. Our goal is myopia control and to give young children the freedom of not having to wear glasses during the day to engage in athletics.
DM was very excited to see so well because it means enhanced vision when doing gymnastics
I reassured DM’s parents that there are many reasons for the left eye to only respond half way. DM’s father helps with insertion/removal. He stated that it was difficult with this because DM is still nervous and squirmish. DM moves and bobs her head and closes her eyes. Instead of being just under a minute withe one try per eye, it took a total of 15 minutes this first few days each time.
When there are many attempts at insertion at night, there are more chances to mildly scratch the cornea. There are more opportunities for the lens not to be inserted centrally. If there is not enough liquid in the bowl of the lens, there may be chances of air bubbles to create a less than ideal seal when sleeping. All of this can result in less than ideal vision the next day.
The family is planning a big trip to visit relatives for the holidays next month and I think we are right on target to wrap up the cases just in time.
DM is the younger sibling of MM. She is becoming more dependent on wearing her glasses at school, even during recess. She also is in gymnastics and is really excited to start the program like her older brother.
What we thought to be an easy case due to a low Rx, turned out to be harder than we thought. We initially tried Paragon CRT lenses, but we found out that they did not center well. The Paragon CRT diagnostic lens is orange.
We will have to order a custom lens that will be larger in diameter and be a 5 curve design to better assist with centration.
After a many weeks of fine tuning the parameters of the lens design, MM was finally getting close to the target.
MM’s dad was very instrumental to helping us get good results by being hands on and engaged in the application process at night. This helps to reduce chances for variability and allowing the troubleshooting skills to focus on how the lens behaves vs poor insertion practices.
Students are always advised to fill up the bowl with solution to the brim, keep their face down and try to make a good effort of not spilling or letting the lens fall off the fingers. This ensures that there is a good seal of the lens. We also encourage patients to go to sleep right away vs stay up and text or read. The lens is designed for a closed eye state in order to get good results.
After a week of wear with the latest design, MM was seeing 20/40 and 20/25. He does not to wear any glasses during the day and can engage in gymnastics w/o any vision issues.
This process took longer than average, but we knew it was not an easy case to begin with more variables to adjust.
We plan to see MM in a week to fine tune the vision so that both eyes are optimal in vision.