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A prosthetic solution “to patch or not to patch”
Provided by
Karen K. Bator-Perillo, ABOC, NCLEC, CPOA Manager,
Technical Sales – Specialty Lenses CIBA Vision Corporation
Case Report
This patient had visited his ECP when the vision in his right eye became blurry and he also noticed a “floater” in his vision. This patient was diagnosed with two retinal tears and was referred to a retinal specialist who performed laser surgery. At his one week follow-up, there was no visual improvement and it was noted that the retinal tears were not healing. The patient was then referred to another specialist who found two additional retinal tears that required laser surgery. It was noted at the next follow-up visit that again the retinal tears were not healing and it was suggested that the patient see yet another “more experienced” doctor, which he did. At this consult, the specialist informed him that the surgery would be quite intense. There would be no guarantee that the surgery would help his vision and there was a possibility the eye could worsen or may need to be enucleated.
At this point the patient consulted with friends and family and decided to continue wearing his “pirate patch” (fig 1) to eliminate the glare.
Figure 1
Three years later, frustrated with wearing the patch and answering questions from strangers and frequent patch replacements, the patient decided to go to another eye doctor. He was informed of a contact lens that could improve his cosmetic appearance as well as occlude much of the light entering the eye. I was consulted on this case and after several trials we used a DuraSoft 3 prosthetic soft contact lens (3 Special Lens) with the following parameters that gave the best fit and color match (fig 2)
Figure 2
D3 Special Lens (Special Eyes Program prosthetic contact lens)
Base Curve 8.6mm
Lens Diameter 14.5mm
ColorBlends Blue with Light underprint 3.7mm black pupil
The fit was optimal with less than .25 movement and the color match was ideal.
The patient is more than satisfied with this option and once again feels “normal.”
Discussion
Although a better cosmetic match was found to be a Misty Gray Double Print, that print pattern did not provide as much occlusion and so the patient preferred
the comfort provided by the underprint. This is proof that sometimes function is more important than cosmesis.
Conclusion
It is extremely gratifying to be able to consult and assist with the fit and color choice for a prosthetic contact lens and literally change an individual’s lifestyle. This patient has since improved his life further as he refers to the contact lens as “the patch that helps me quit smoking” since after 31 years of smoking he now uses that money to pay for his prosthetic lens, solutions and doctor visits. He has stated that he will gladly refer others to this option and wishes he was aware of this option prior to the failed surgeries. This case and all the others I consult on make me very proud that we have the technology to manufacture and supply these lenses to thousands of sighted and non sighted patients. Fitting prosthetic soft contact lenses is challenging yet rewarding. We have the opportunity to improve the patient's physical appearance thus improving their emotional and psychological status.
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