Background
With up to 20% of children affected by seasonal allergies¹ and many requiring regular eye drops, daytime contact lens wear can become difficult during peak allergy seasons. This case shows how orthokeratology can help an active teenager control myopia while continuing to enjoy sport free from the discomfort and inconvenience of daytime lenses.
ITAL LENT
Design: Ortho-K Alexa AR
Material: Optimum Infinite (180 Dk)
Patient History
Background:
– Myopia diagnosed several years ago, still progressing
– History of allergic rhinitis
Initial Clinical Findings
RE 20/70
LE 20/150
RE -1.00 -1.00*10
LE -2.00 -1.00*175
RE 42.00/44.00*170 K AVG 43.00
LE 42.50/44.00*10 K AVG 43.25
Biomicroscopy
Generalised grade 3 papillary conjunctivitis is observed in both eyes, indicating significant inflammation that could cause discomfort when fitting contact lenses. Break up time (BUT) 5 seconds in both eyes.
Corneal Topography
It is concluded that the patient is suitable for Orthokeratology treatment using the Alexa AR design and Optimum Infinite material.
Trials are carried out according to the design recommendations. An anti-inflammatory is recommended to improve the anterior segment, making the patient suitable for orthokeratology fitting.
Final Lenses
| EYE | TOR | C PW | C POT | DIA | DESIGN |
| OD | T12 | K | 02 | 10.8 | ALEXA AR |
| OS | T12 | L | 03 | 10.8 | ALEXA AR |
Post-Moulding Topography
Post-treatment topography showed a perfectly oblate pattern with the treatment zone well centred in both eyes. Corneal health remained excellent, with no staining or anterior segment changes, demonstrating the effectiveness of high oxygen transmissibility.
RECOMMENDED MATERIAL:
Justification for the Material: Why Optimum Infinite (180 Dk)?
- Ocular Surface Compromise: “I knew the patient had an inflammatory predisposition (GPC and allergies). Choosing Infinite (180 Dk) instead of a Dk 100 was not optional; it was a critical safety measure. A cornea with a low BUT and inflammatory history requires maximum oxygenation during overnight wear to avoid any hypoxic stress that could reactivate the papillary response.”
- Hours of sleep: To ensure maximum oxygen capacity during sleeping hours, thereby guaranteeing good ocular health.
- Final VA (unaided): RE 20/20 LE 20/20
- Topography: A satisfactory oblate pattern is observed with a reduction in the initial keratometric values, confirming effective corneal moulding.
- Ocular Health: The cornea remains healthy and free of staining, validating the safety of Infinite material for prolonged Ortho-K treatments.
References
1.https://www.cdc.gov/nchs/products/databriefs/db546.htm#:~:text=Diagnosed%20Allergic%20Conditions%20in,McClain%2C%20M.P.H.
