TN started our myopia control program on 5/26/16. We have seen him for for 3 exams prior and every year, his vision keeps getting worse. His mom decided that she wanted to do something to try and stop his eyes from getting worse. We decided that the iSEE lens was best for him.
The one day post iSEE vision was 20/80 and 20/200.
4 days later, he was seeing 20/40 in each eye.
11 days later he is seeing 20/20– and 20/30++.
At this time, I consulted with the lab and ordered a new pair of lenses. The topographies looked great and there was no keratitis. He was inserting and removing the lenses with great care all by himself.
TN is on a summer vacation this week enjoying great vision so far. When he returns, he will pick up the new set of lenses and we hope that his vision will be fine tuned to 20/20 in each eye.
KN started our myopia control program 2/27/16. It was not easy for KN to start, but he’s making progress every time we see him. KN was slightly anxious, which made taking pictures and maps challenging.
At the beginning, his father helped to insert and remove the lenses for him to fast track his progress. This sometimes is important so that we can get good measurable results so that we don’t get misleading maps or outcomes.
Because of his astigmatism, we decided to start with the iSEE Advanced Ortho-K lenses.
We reached 20/25– and 20/50– upon one week of wearing the lenses.
After 3 weeks, we got 20/20 and 20/25++. There was just a centration issue with the left eye that we had to fine tune, but no other issues with the system.
Our plan was to teach him to be self sufficient by the end of summer so that he does not have to rely on his father for help.
Today, June 28, 2016, KN is seeing 20/20 in each eye. We reviewed insertion and removal techniques for KN and felt comfortable in seeing him in the fall.
KN is now on a 3 month follow up schedule.
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.
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MM came in for his follow up on Tuesday night at 6PM and was seeing 20/20 in each eye. He reports no troubles with the lenses, no dryness, no glare.
MM did try the Paragon CRT orthokeratology lens initially, but we found that they didn’t fit his eyes as well.
Because of the iSEE’s 5 curve design, it can treat prescriptions up to -10.00 diopters of myopia and up to -4.00 diopters of astigmatism.
The iSEE Advanced Custom Ortho-k. After some revisions, this fits nicely on MM’s eyes and now he is on a maintenance schedule.
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.