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Showing posts from 2015

Dry Eyes

Dry eye can really stir some emotional issues with patients experiencing them. Generally, lubricating drops are being prescribed.  In some cases, the whole regimen of steroids, warm compress, lid scrubs, cyclosporine drops are being given.  Many get by with just using the drops, however, we have seen even the toughest individual shatter, completely broken down and incapacitated by their dry eyes.  Dry eyes cannot really be treated, but can be managed considerably.  The patient and the doctor has to find the sweet spot and the balance for the regimen to work their wonders. Looking for the right combination is a crucial thing.  Definitely with compliance, patient's issue of grittiness, stinging sensation will improve.  It does not work in a day or  in a week.  But definitely in a month's time, improvement can be felt and seen.  Scleral lenses can also play a big part in dry eye management.  As the bowl of the contact lens is filled with liquid, then the cornea is bathe in moistu…

Is Collagen Cross Linking A Must?

We know that keratoconus is a condition that progresses and can lead to possible corneal transplants.  With scleral lenses, indeed we can delay that by still proving functional vision to patients, however, we still believe that collagen cross linking is a must to strengthen the chemical bonds in the cornea.  It is a simple process where the ophthalmologist will expose your cornea to UV light and put riboflavin or Vit B2 drops on it for every few minutes.  This can either be done with the corneal epithelium off or intact.   After the procedure, your corneal collagen bonds will be stronger resisting the fast progression of the cone.  This will give you stability of vision as well.  
Who are candidates for collagen cross linking?
It is best for patients with keratoconus to have this procedure done earlier, before the cornea becomes too irregular and too thin.  
When will it be a good time to wear contact lens again?
Well, it depends on the ophthalmologist who did the procedure.  But normally…

Patience in Keratoconus

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I had a patient referred to me for contact lens fitting.  This 20 year old patient was just diagnosed with keratoconus.  His parents came with him.  They waited for me to see them.  After doing a thorough check, I pointed to the parents the scar that formed on the patient's cornea.  The parents were very sorry that they had not noticed it.  I fitted the patient with scleral contact lenses.  After which I taught him the insertion and removal technique.  As I do the training myself, we had to block off my schedule to prioritise this case.  It took us more than a visit for him to be able to insert the lenses as his lids kept on closing.  The parents were very supportive and stayed with us throughout this ordeal.  For most families in the Philippines, optometrist visits are a family event.  Family support is truly an important part of a successful contact lens wear, as no one can motivate more than patient's own family. After showing how much vision improvement we were able to at…

What is keratoconus?

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Keratoconus is a condition wherein the front transparent portion of the eye (cornea) thins down and become cone shaped.  Until now, reasons why this disease came along is unknown; but somehow keratoconus is usually always associated with history of eye rubbing and allergies.  Genetics also play a role in the pathogenesis.  Family history of consanguinity marriage is also being looked at as one of the possible associations.  Patients with keratoconus may notice the need to change their eyeglasses every now and then, not being satisfied with the attained vision with their eyeglasses.  This disease may or may not lead to corneal transplant, it all depends on what age keratoconus has manifested or was diagnosed.  In the beginning, soft toric contact lenses are sufficient, but eventually needing to proceed to the use of specialty rgp contact lenses, Kerfasoft IC, scleral contact lenses.  These management options are all available in the Philippines.