Synergeyes case 1
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Transcript of Synergeyes case 1
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Synergeyes case 1
Derek Louie
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• 35 y.o male presented 2009 for gradual progressive blur @ distance OD>OS x 5 years. Wears reading glasses to help @ near, but getting worse.
VAs SC Near sc PH Right eye 20/200 / / / 20/40 Left eye 20/30 / / / 20/20 OU Current glasses none• Manifest here: Manifest sphere cylinder axis Visual
acuity Right eye -2.00 -3.50 011 20/60 Left eye -0.25 -1.00 111 20/20 Near add //+1.25 /,/
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• Exam findings:– Cornea OD – fleisher’s ring 1+ straie, no scarring– Cornea OS – clear– All other findings WNL
• Humphery atlas ordered. • Keratoconus Dx, OD>>OS – see topography• Fit last year with Synergeyes A lens, good
correction OD only. • Final lens: Synergeyes A/ 7.1 (8.4 skirt)/ -
2.75/14.5 ---20/25 • Did well, returns this year with no problems for
annual medical exam
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Humphery topography 7/2009
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Returned for annual exam 10/2010
• No problems with vision, good comfort of lens, vision seems stable.
• 20/30 OD (thru hybrid lens)• 20/25 OS (uncorrected)• Cornea OD– 1+ punctate staining central inferior, no scarring– All other findings WNL
• Plan: Refit OD with steeper BC/different lens design
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• Initial Dx lens: Clearkone 250 vault/-4.50/14.5/ medium skirt• Clearance central and light feather touch in ILZ, good movement
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• +3.50 Over-refraction of diagnostic lens = 20/30 vision
• Likely may improve when SPK/PEE resolves • RTC 2 weeks for contact lens/cornea check
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• Decreased Vault: ClearKone 200 vault/-3.00/14.5/ medium skirt, • Good movement (0.25 MOB) but too much touch central and in ILZ
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Synergeyes Case 2 (if needed)• 8 year old female with h/o traumatic corneal
laceration due to stabbing herself in the right eye with a small knife when she was 3 y.o.
• Wore aphakic CL for several years, recently had sewn in IOL and pupilloplasty
• Best corrected vision with spectacles (+5.00-6.00x010) 20/100, ph 20/80– OS 20/20 sc
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• Started with synergeyes A/7.9/-3.00/14.5+2.50 OR = 20/80 distance VA, 20/400 near
• Ordered in slightly steeper b/c to improve fit, and considered multifocal option for near VA
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Final CL Rx:
Synergeyes M /7.8 BC /-1.00,+2.25 add (2.2 seg size) /8.8 skirt/14.520/80 (ph20/70) with 20/60 near
No improvement with over-refraction @ distance or near
Referred for VT/ambylopia tx.
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