A 27-year-old woman was referred from the Clinica de Madrid (June 2006), diagnosed and treated for congenital glaucoma since birth, to adapt contact lenses.
The patient also had nystagmus.
In the ocular history, the patient reported four surgeries in each eye from birth to ten years old, followed by implantation of a shunt at 18 and 21 years old in both eyes.
Currently, the patient continues to receive pharmacological treatment for OD and ocular gloves in OA.
The patient carries -11.75 D gafa compensation in BE with which VA reaches 0.05 and 0.16 in RE and LE respectively.
We made subjective refraction and with it:
OD: -14.00 D and OI: -14.00 - 1.00 to 90o reaches a VA less than 0.05 and 0.2 + for each eye respectively.
The corneal topography showed corneal irregularities in both eyes.
1.
Pupils show alterations in shape, decentralized position and mean diameters of 3 and 6 mm respectively in RE and LE.
The biomicroscopic evaluation of the cornea shows decreased corneal transparency, poor tear quality presenting a tear break time of 2 seconds, and diffuse staining with fluorescein more located in the lower third of the cornea.
The corneal diameter is 16 mm in both eyes.
After evaluating the results of the evaluation, it was decided to begin the adaptation with LRPG.
Several tests were performed and the final lenses that are adapted are RPG Confort (Contamac®, UK) spherical-designed (AZV Oxicon® Comfort) lenses of the Lenti laboratory
This material is made up of a combination of high purity fluorsilicon with a hydrophilic component and a 60 modified Fatt.
1.
The VA achieved by the patient is for the RE: 0.05, LE: 0.3+1 and binocular: 0.4 -2.
The size of the lenses is progressive up to a maximum of 8 to 10 hours, always in daily use.
The patient initially reported difficulties in close vision with contact lenses from the beginning of the adaptation to the usual month of size.
This is because in a myopic eye the convergence and accommodation required with contact lenses is greater than that used with glasses (2).
In October 2006, the patient suffered a fall that caused trauma with choroidal detachment of the left eye, requiring new intervention in this eye.
Once treated, in January 2007 the missing lenses were replaced during the fall.
Alterations in the left eye require slight modifications in potency (-13.00 D) and eccentricity (0.4) left lens with 0.3-2 oD lenses in AV, after 4 months using 0.05 occluder.
During the adaptation process, its IO presents staining located in the inferonasal zone, without mechanical cause by the contact lens.
The lesion does not subside by suspending the size of the lenses.
The patient was referred to the ophthalmologist who diagnosed the lesion as a trophic ulcer, starting treatment with autologous serum that resolved the lesion one month after treatment (3).
Then continue to use contact lenses daily.
