Bizarre Eye Exam with ortho K lens
YesAtropine .1% daily
9 year old girl has been on OrthoK lenses for 1.5yrs with no issues. Last exam was 1 week ago and she was seeing 20/20 with lenses out for 8 hours. Today at her exam without warning she was unable to see the eye chart at all and best correction was poor. She had just contracted a sinus infection two days prior and was complaining of headache, nasal congestion, and pressure behind the nose. What is confusing is that with her OrthoK lenses in she has no vision problems. See exam details below:
With orthoK lenses out:
Could not read the 20/100 line in both eyes.
Best corrected vision using refraction or through pinhole was 20/60 at best.
Corneas looked clear and topography/map was normal for OrthoK (flat top)
Optic nerves were normal.
Field of vision test (machine) was not reliable.
Field of vision test (fingers) was just ok (mostly correct with difficulty)
With orthoK lenses in:
Could read 20/20 line with ease in both eyes. Some of the 20/15 line.
Field of vision test (fingers) was perfect with no hesitation.
Thanks for your Question
It seems that you might need a new lens. Refractive power in kids is unstable and it keeps changing with time. I would recommend to discontinue the ortho k lenses for 1-2 weeks until the shape fo the cornea is reversed back to its original shape. Use preservative free lubricant eye drops during this time. After 2 weeks you have to do a new refraction and images of the cornea for a new set of ortho k lenses. New corneal topographic modalities with new customized lens design software can be very accurate.
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