The presenters gave four very interesting and different cases including the following:

Case One: THE KERATOCONUS PATIENT

The Keratoconus Patient Case Gelles

Information: 35 y/o female referred for corneal crosslinking. She did not realize she had keratoconus and had wearing glasses her entire life. Had moderate-severe KCN 55.9/59.4 central cone IS ratio OD 12D. OS 15.3. Difference from top to bottom very significant. Refraction: OD: Pl – 4.00 x 090 OS: Pl – 5.50 x 090. Diagnosed with a large amount of coma, trefoil and spherical aberration.

What to do?

Scleral lenses good option; dispense & she says she is looking through a fishbowl . . sees 20/20-

Two Options:

1. Custom soft lenses which can minimize the aberrations
2. Scleral lenses

PEARLS

Scleral lenses are not always the answer

Selection Considerations

• Refraction: if better than 20/30 consider soft
• Rigid lens OR: if patient isn’t enthusiastic about this visual result, think soft
• Topography: if ≥ 10D of asymmetry, consider a scleral

SPOTLIGHT ON EDUCATION PART II:

“Expanding Your Practice through Education: Becoming a Specialty Contact Lens Externship”

Moderator: Dr. Gloria Chiu

Panelists: Drs. John Gelles, Barry Eiden, Marsha Malooley, and Ashley Tucker

This program was sponsored by a very distinquished group of contact lens specialists in the US who meet and share “best practices” in eye care and new technologies: the Society of Eye Care Specialists. This includes Drs. Robert L. Davis, Jeffrey Sonsino, Jordan Kassalow, Amy Nau, Douglas Inns, Aaron McNulty, Moshe Schwartz, Lamar Zigler, Barry Eiden, Todd Bowman, Jeff Cooper, Randall Fuerst, David Seibel, Selina McGee, and Shalu Pal.

Dr. Chiu initially recognized the Specialty Contact Lens Clinical Externship Committee which includes her as Chair, and GPLI Advisory Board and “Rising Star” committee members Drs. Anita Gulmiri, Dan Fuller, Pam Satjawatcharaphong, Laurel Kelley, Mari Fujimoto, Grace Tseng, Madison Moss, and Dr. Sherry Mei.

The goal of this program is to significantly increase the number of specialty contact lens clinical externship sites. The purpose of the webinar was to identify challenges and how to overcome them, understand logistics of student rotations, and encourage more optometrists to consider hosting interns in your practice. All four experts on the panel have a lengthy history of having clinical externs rotating through their practice and they provided input to several questions.