Clinical Scorecard: CONTACT LENS CASE REPORTS

At a Glance

Key Highlights

• Scleral lenses improve stability and comfort for keratoconus patients.
• Piggybacking corneal GP lenses on soft lenses can enhance comfort for patients unable to adapt to scleral lenses.
• Daily disposable silicone hydrogel lenses are recommended for piggybacking.
• Custom soft lenses may be necessary for severe keratoconus cases.
• Hydrogen peroxide care systems are advised for GP lenses to prevent interactions.

Guideline-Based Recommendations

Diagnosis

• Assess keratoconus severity and previous lens fitting success.

Management

• Start with corneal GP lenses; if unsuccessful, consider piggybacking with soft lenses.

Monitoring & Follow-up

• Regular follow-ups to assess comfort and lens fit.

Risks

• Potential for corneal edema with improper lens fit.

Patient & Prescribing Data

Keratoconus patients, particularly those with prior lens fitting failures.

Daily disposable lenses with high sagittal depth are preferred for comfort and stability.

Clinical Best Practices

• Fit larger-diameter GP lenses to enhance stability.
• Utilize daily disposables to simplify lens care.
• Consider custom soft lenses for severe keratoconus.

References

• Koppen et al, 2018
• van der Worp et al, 2021