AP has been through our myopia control program for over 1 month. His vision is excellent at 20/20 in each eye. There is no eye irritation and he’s enjoying clear and crisp vision all day long.
After 2 weeks of me inserting the iSEE lenses, AP decided to be brave and try to insert the lenses himself. I am very relieved to be hands off, but there are some cautions for parents out there who are not watching their kids.
I’ve noticed that AP does not clean the DMV plunger as well as I’d like. We wash with hot water and rinse off at the end with a multipurpose disinfectant.
I’ve also noticed that he touches the lens on the inside on multiple occasions and this may lead to discomfort and multiple insertions. I’ve given him tips to pick up a dropped lens with a plunger and to handle the lenses on the edges only.
We are currently using peroxide to disinfect, unique pH as the cushioning drop upon insertion, and just a multipurpose solution for the rinse.
And finally, after he leaves for school, I look in his room and find open bottles of solutions without a cap.
Careful attention to detail can help ensure better performance and reducing chances of bad luck.
My very own son , AP was detected to be nearsighted this year when he went to the pediatrician in January and didn’t see the 20/20 line. I had just screened his vision before school started (August), so this came on very fast and as a surprise to both of us. For us parents, this meant put the brakes on the myopia ASAP. AP went straight into the myopia control program, skipping glasses.
I ordered a pair of iSEE Advanced Orthokeratology lenses for AP right after I did the refraction and took topographical maps of his eyes. Due to the unique shape of his eyes, he was not a candidate for the simpler Paragon CRT lenses, even though his Rx was so small. We did a software analysis using the collected data points to come to this conclusion.
AP started our myopia control program early March. At the beginning, I am still inserting and removing the lenses from his eyes. Our goal is summer for him to do it himself.
The first few days have been challenging only because he was very vocal about discomfort every little thing that bothered him. It was not easy with insertion/removal because his lids were tight and his eyes were small. I would have to remove and reinsert at least once for the first few weeks.
I now can empathize with parents who go through this process for their younger children. I hope that I can offer real practice advice to parents now that I am living the process, not just teaching it.
AI started our program in June 2014. Today, she came in for her 2 year annual progress report.
Her uncorrected vision right eye is 20/20 and 20/25 left eye.
She has no complaints about her program and is very consistent with the recommended guidelines. She is wearing Paragon CRT.
The lenses were deep cleaned and inspected yesterday before the annual visit.
There were no issues on her corneas and the topographies looked great.
I gave her parents the go ahead to continue with the program without any changes and I will follow up in 3 months.
Below is a sample of her topography 3 months ago and today. The difference may be due to the deep cleaning that was done yesterday. There was one line of improvement in today’s outcome vs April 2016 for the right eye.
AR came back for her annual examination and she was still seeing 20/20 in each eye. We deep cleaned the lenses with Menicon’s Progent enzymatic cleaner last week to ensure that we got optimal topographies.
We are please with the outcome so far and there was no plan to make any changes to AR’s lenses at this time. Mom wanted to order a new pair and keep the old one as a back up.
The maps look very consistent from Nov 2015 to May 2016. AR is wearing a Paragon Dual Axis CRT in the right eye and a Paragon CRT lens in the left eye.
There were some questions about insertion/removal techniques and we plan to address them next week.
Paragon CRT Dual Axis
MW came in for a 4 mo progress visit. Her vision is still 20/20 in each eye. No complaints or issues with dry eyes, glare, blurry vision or discomfort.
MW has done a remarkable job with being independent and consistent with insertion/removal and cleaning.
At the visit in January, I saw some keratitis in one eye and requested that she come back in 1 month so I can investigate if it is recurrent.
MW came in today, Feb 28, reporting that she did not wear her lenses last night. Her visit was at noon and each eye was seeing 20/30 and combined 20/25. She came home late last night and forgot to insert the lenses.
The keratitis has resolved and MW speculated that it was caused by an eyelash in her eye the night before.
MW is doing well and I plan to see her 3 months.
AS came back for her 9 mo progress evaluation. Right eye was seeing 20/20 and her left eye was seeing 20/20–.
No complaints of glare/ haloes, dryness or blur. The visit was done at 4PM, so there may be some fade of the treatment from the morning. I inquired on how she takes out the lenses and found out that she does not insert any eye drops prior to removal. I explained and showed her that the keratitis that I see may be related to her lack of attention to putting in drops to lubricate the eyes before removal.
Her parents tell me that she is independent and can insert and remove the lenses by herself. I found out that maybe one day per week, usually on Friday night, she might fall asleep in the car while traveling and may take a day off from wearing them.
Our plan is to ask her father to bring the lenses back in the morning on Tuesday so that the staff can deep clean the lenses to recondition them back to close to new again. Protein can build up over time to cause the lenses to not perform as well.
AS is in good shape with her treatment and we will see her in 3 months for her annual visit.
DT came to see us after seeing his new Rx change from -3.75 and -3.25 to -5.00 and -4.75 in one year. His older glasses was -1.50 for both eyes. They live 35 miles away from the office, so I knew that getting here was no easy drive.
6/25/15 Paragon Continue reading