#Bascom palmer contact lens full
Confrontational visual fields were full to finger counting in both eyes, and extraocular motility was full in both eyes. His pupils were equal, round and reactive to direct and consensual illumination, and no afferent pupillary defect was observed in either eye. Visual acuities with his current scleral contact lenses (ScCLs) were 20/60 in the right eye and 20/400 in the left eye. Despite these treatments, the patient continued to have severe ocular dryness, for which scleral lenses had been fitted. For his dry eye symptoms, he was using over-the-counter artificial tear drops, autologous serum eye drops and topical steroids, and had had plugs inserted in all four punctae. He had been taking 20 mg of Plaquenil daily for the last 10 years, prescribed for his Sjögren’s syndrome.
In addition, he had a history of hypertension, hyperlipidemia, anxiety, depression, and prostate cancer. He had no history of glaucoma or trauma and no family history of ocular disease. The patient reported that the latter was no longer active but that owing to a recent flare-up, he had retinochoroiditis, leaving him with very poor central vision in that eye. A review of his ocular history revealed severe keratoconjunctivitis sicca caused by Sjögren’s syndrome and acquired toxoplasmosis of the left eye. He reported having worn the lens only four times since they were originally dispensed because of discomfort. He was wearing his scleral lenses but complained of significant lens awareness and foggy, dirty lenses.
A 71-year-old man presented to the Miami Contact Lens Institute for a scleral lens refit.
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