/ /

  • linkedin
  • Increase Font
  • Sharebar

    Managing the astigmatic patient with contact lenses

    Case examples show how different lenses work for different patients with toric needs


    Case 2

    12-year-old male

    The child has broken multiple pairs of glasses and refuses to wear them. His mother is concerned that he will lose contact lenses and wants him to have something disposable so he will have spares.


    OD: +2.75-2.75 x 020; 20/40; SimKs 43.20/46.25

    OS: +2.75-4.25 x 160; 20/40; Sim Ks 42.47/46.21

    Figure 7. OD and OS topographies showing high regular astigmatism.


    See Figure 7 for topographies.

    I prescribed custom soft toric monthly replacement contact lenses.

    Related: Managing astigmats when they hit presybopia

    OD: +3.25-3.25 x 010; 8.7 mm base curve; 14.5 mm diameter; 20/25

    OS: +3.00-3.75 x 165; 8.7 mm base curve; 14.5 mm diameter; 20/30

    The patient very successful with application and removal. At the six-month follow-up visit, his parent reports improved academic success.

    Figures 8 (top) and 9 (bottom). High slightly asymmetric astigmatism OD and OS.

    Case 3

    8-year-old female

    Parents report that the patient does not wear her spectacles, and they would like her to try contact lenses.


    OD: +0.50-2.50x010; 20/20; SimKs           41.03/43.07 

    OS: +1.25-2.75x163; 20/30; SimKs           40.44/43.50

    Bitoric GPs were designed using a saddle technique and ordered based on an over-refraction on Pl/-3.00; 41.00/43.00; 9.2 mm diagnostic lenses.

    Figures 10 (top) and 11 (bottom). Very high regular astigmatism with no evidence of ectasia.

    Final lenses were:

    OD: -0.25/-2.25; 41.00/43.00; 9.0 mm; 20/20

    OS: -0.50/-2.50; 41.00/43.00; 9.0 mm; 20/25

    Related: 5 reasons ODs don’t fit toric contact lenses

    The child and parents were successful with application and removal. The patient wore lenses for school with good success.

    Renee E. Reeder, OD, FAAO, FBCLA, FSLS, FIACLE
    Dr. Reeder is coursemaster for the specialty contact lens, microbiology, and anterior segment disease courses; the educational ...


    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available

    Optometry Times A/V