Clinical Report: Online Photo Diagnosis

Overview

A 17-year-old female with congenital distichiasis and fluctuating vision on soft toric lenses was evaluated. After unsuccessful trials with various soft lenses, she achieved improved stability and comfort with scleral lenses.

Background

Congenital distichiasis is a rare genetic condition that can complicate contact lens fitting due to the presence of an additional row of eyelashes. This condition can affect lens stability and overall visual acuity, making it essential for clinicians to consider alternative lens options. Understanding the implications of congenital distichiasis on contact lens wear is crucial for optimizing patient outcomes.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

• The patient had moderate to high with-the-rule astigmatism and low myopia.
• Congenital distichiasis was identified as a contributing factor to lens instability.
• Initial attempts with different soft toric lenses did not improve visual stability.
• Scleral lenses provided better fit and comfort compared to soft toric lenses.
• Management options for symptomatic distichiasis include cryotherapy and laser treatments, though not necessary in asymptomatic cases.

Clinical Implications

Clinicians should be aware of the impact of congenital distichiasis on contact lens fitting and consider scleral lenses as a viable option for patients experiencing lens instability. Regular monitoring and patient education on lens hygiene and fit are essential for optimizing visual outcomes.

Conclusion

Congenital distichiasis, while rare, can significantly affect contact lens wear. Scleral lenses may offer a successful alternative for patients with this condition who experience fluctuating vision.

References

1. William Townsend, OD, FAAO, Contact Lens Spectrum, 2021 -- Online Photo Diagnosis
2. Corneal Ectasia Preferred Practice Pattern® - PubMed
3. International Contact Lens Prescribing in 2025 | Contact Lens Spectrum
4. Corneal Ectasia Preferred Practice Pattern® - PubMed
5. International Contact Lens Prescribing in 2025 | Contact Lens Spectrum
6. IMI - Interventions for Controlling Myopia Onset and