Clinical Scorecard: Custom Soft Corner: Seeing Single Again

At a Glance

Key Highlights

• Custom soft contact lenses (SCLs) provide a versatile alternative to traditional treatments for diplopia.
• Monocular diplopia can be treated with standard toric SCLs, while irregular astigmatism requires custom SCLs.
• Custom SCLs can utilize monovision, occlusion, or directional prism to address binocular diplopia.
• SCLs can incorporate up to 5.0 PD of prism for rotational stability.
• A thorough eye exam is essential before fitting SCLs for diplopia.

Guideline-Based Recommendations

Diagnosis

• Conduct a comprehensive eye exam to determine the cause of diplopia.

Management

• Consider custom SCLs for managing diplopia, utilizing monovision, occlusion, or directional prism as needed.

Monitoring & Follow-up

• Monitor for symptoms such as asthenopia, nausea, and visual discomfort, especially with vertical prism disparities.

Risks

• Counsel patients on the potential sacrifice of binocular depth perception with monovision and occlusion.

Patient & Prescribing Data

Patients with diplopia due to muscle imbalances, neurologic issues, or astigmatism.

Custom SCLs can enhance visual function, comfort, and appearance for diplopia patients.

Clinical Best Practices

• Ensure careful lens selection and fitting for optimal patient outcomes.
• Educate patients about the implications of treatment options on depth perception.

References

• Lampa M. Custom soft lenses for irregular astigmatism.
• Lee SK, Zabrowski C, Lee MS. Management of diplopia using contact lens.
• Astin CL. The use of occluding tinted contact lenses.
• SpecialEyes. Benefits of customizing prism with custom soft toric contact lenses.
• Sulley A, et al. Resultant vertical prism in toric soft contact lenses.
• Nilsson M, et al. Vertical imbalance induced by prism-ballasted soft toric contact lenses fitted unilaterally.