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.
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
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.
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.
MM came into our clinic late August for a consultation. MM was actually seen 2 weeks prior somewhere else for a general examination, but his father mentioned that no myopia control treatment options were offered.
MM’s parents were excited to offer his son a chance at stopping his Rx from getting worse and options of being able to engage in sports without the need for glasses during the day. MM is the older brother and has the highest Rx in the family so far. His mother does not have any correction. Younger sister is 7 yo with a -1.00 D Rx. Father has a -4.00 D Rx.
Initially we tried the Paragon CRT extended range orthokeratology lenses, but they did not fit well, and his response to the treatment the next day was minimal.
MM’s father was very motivated to continue the journey to finding a lens that will give MM a better chance a success. I outlined to his father that I was confident that we could find another manufacturer that would help his son.
We ordered the iSEE lens from GP Specialists. The iSEE lens is a 5 curve design vs the 3 curve design. which means that this case is more complex with so many variables to adjust.
EZ started our program 6 days ago. At the one day post treatment, EZ was seeing 20/30 and 20/20 at 8:30 AM. The lenses look centered and there was no discomfort. I reviewed with EZ and mom that everything is going well. EZ was seeing about the same as the old glasses from last year.
I requested to see EZ in the evening time 1 week later for a progress evaluation. At this visit, EZ was seeing 20/25 in each eye. I reassured that this normal because in the evening time the treatment may fade a little bit.
EZ did not have any complaints. No complaints of irritation, dryness, or haloes/glare at night.
EZ will follow up with me in 2 weeks in the morning.