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    Managing astigmats when they hit presybopia

    Many options allow patients to remain in contact lenses

    As you spin your Jackson Cross Cylinder (JCC), you hope for the white dots to be selected. Oh, the happiness a spherical patient can bring to your day. Young or old, it doesn’t matter, their refractions are faster, their adaptation to everything is easier, and their contact lens fits are a bit easier and a little faster. Fingers crossed your new patient sitting in your chair falls into this group.

    Cylinder has been accepted, and now the panic sets in—what’s the axis? Is it oblique? Oh, don’t let it be oblique! How high will it go? I’m thinking of the redos in my future, the distortion, the crooked walls and tilted floors, the headaches and strain, the toric lenses, the shadows, and all the explaining that has to be done.

    Years ago, we thought this was our fate, but today there is no need to stress.

    After I bought my practice, I heard too often from patients they were told they were not candidates for contact lenses because they had a disease called “astigma.” The options available for our patients and the ease in which we can fit our patients have dramatically changed—especially for presybopes and astigmats. Astigmatism is no longer a scary prescription that we need to shy away from fitting contacts.

    Fitting toric patients is a breeze today, and we have options to allow those patients to continue to stay in their contact lenses as they become presbyopic.

    Shalu Pal, BSc, OD, FAAO
    Dr. Pal earned her Doctor of Optometry degree from Southern California College of Optometry and completed a cornea, contact lens, and ...


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    Optometry Times A/V