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Consider entire peripheral cornea when fitting irregular topography
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NEW YORK – Centration, apical clearance and unobstructed vertical movement are the primary objectives in lens fitting for the irregular cornea.
Jennifer Smythe, OD discussed clinical pearls for fitting the irregular cornea on day 2 of the PRIMARY CARE OPTOMETRY NEWS Symposium here.
“We need to appreciate the asymmetry of the corneal topography in keratoconus,” she said.
She said in fitting these patients, the lens is always tightest where the cornea is flattest, and the lens is always loosest where the cornea is steepest. “The biggest pearl I have to offer is you really have to take into consideration the entire peripheral cornea, not just the area that is steepest,” she said.
Dr. Smythe also discussed the irregular topography of the postsurgical cornea, which is often associated with tight suture steepness, wound tilt and wound gape. “This is where traditional reverse-geometry lenses fail,” she said.
For these types of cases, Dr. Smythe said she may use a mini-scleral or semi-scleral lens such as the Jupiter Lens by Innovations In Sight.