Discussion Board


The extracts below have been taken from social networking or similar discussion sites and are reproduced here for your information.  If you wish to read more, the source information is included at the conclusion of the discussion.

Topic:  Keratoconus;  Facebook Discussion Board, c. 2010

Bilal

do u use toric RGP (HARD LENSES) to manage K.C? What is ur perfect lens type, design and material?

Robin

Thats hard to say because everybodys different and the design, material and fit really depend on each patients problem.  In our office the durasil II is usually sucessful and a lot of the times you need a reverse curve for a good fit.  But really it just depends on each individual patient and what their eye is shaped like and how comfortable they are going to feel in differencet lens designs amny times you have to try several lens types before you find something that works

Rajesh

Dear Bilal,

I have now fitted several keratoconus patients woth RGP lenses.  Almost half of these "regular RGP" patients were refitted with "Rose k lens" results are encouraging:

- Several best corrected 6/60 eyes improved to 8/18p or better, 6/12p improved to 6/9 or better

- Apical staining disappeared

- Comfort and stability was markedly better

- Works well with all levels of cone.  Early to advanced.  The steepest BC that I have fitted so far is 4.50mm (this was equivalent to 83D K reading and that too irregular).

- We source it from Boston UK

- The lens design is a) Small optic zone b) Aberration control in optic zone c) Multicurved intermediate and peripheral zones d) variuos options in edge lift

- dk value is 31 units

- Patient needs to come for trial (1.5 hours) and then after 2 weeks for delivery (1 hour again)

- The final lens is identical to vision and comfort and objectively seen fitting in the trial sitting

Optom.Rajesh Wadhwa
Optometrist,New Delhi,India
M.Optom.
B.Ophth.Tech Hons.(AIIMS)
B.Sc.Hons. (DU)
Fellow of International Assoc. of Contact Lens Educators (Australia)
PG Dip. in Management

Bilal

dear rajesh

I agree with you about rose k you know? sometimes I dont beleave what this lens can do. today I was fitting a 22 years old pt no glasses no contact lenses befor an she thinking that all peole are seeing like her but she discover that something wrong when her V.A = C.F @ 1.00 M. When I saw her I was afraid that she is know amblyopic.  I asked my assestant to do topography but the result was error (can't be mesured) after 30 min she was 20/28. you know sometimes i dont beleave that it is happening. and i realise how much our jop is wonderful and important.

I worked befor with soper cone,mcguir, and fifferecnt kind of R.G.Ps but like ROSE K i didn't see yet i think it is perfect u can design the lens toric,toric periphery,ACD (ASYMETRICAL CORNEAS DESIGHN) AND MULIBLE edge left avalibe simply it is perfect and i am asking my qus and make it a head line to discuss to see if optometrists all around having the same idea or i am exceeding borders when i am thinking about it

any way thank u about your interest and sharing me this discussion and hope that we will be in contact to update each other and to have someone to talk about our jop

Bilal Rawashdeh
cheif od contact lens department
Magrabi Hosiptals & Centers / Makkah
belaln105 "at" yahoo.com
 

Nguyen

Hi everyone, I am a current Third Year in Optometry School at PUCO.  To all current Docs out there, about what is the incident of Keratoconus that you encounter each year?  From some indications, especially from our Contact Lens Specialist (Pat Caroline), the incident of Keratoconus is kinda high, especially since we now have much better instruments for detecting corneal irregularities (Topography).  Any thoughts?

Bilal

it depends about the area of study, wher u r looking for in our region (middle east) its high. am seeing about 3 cases daily out of about 40. in other areas here, one of my colleagues seeing about 10 to 15 pt daily. i might finish a study project this uear about kc incedent.  check one of these studies, showing the study results and compare it to other results arround the world. The ability to describe the incidence of a disease is important for predicting current and future clinical needs, and for establishing disease characteristics in a particular population.  This study found an incidence of keratoconus in Asir Province, Saudi Arabia, to be 20 per 100000 based on referrals to the provincial, tertiary level specialist clinic. This compares with 1 per 100000 in the United Kingdom,7 2 per 100000 in Minnesota (USA), 4 2.2 per 100000 in Finland, 5 2.5 per 100000 in Holland, 8 and 50 per 100000 in New Zealand.6

for more please refer to http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1772915

Note:  Grammatical and spelling errors belong to the original author.