SPECIALISTIC CONTACT LENSES

Contact lens intolerance is very rare and most of the time the result of incorrect applications or skepticism of the patient

It can be safely stated that there are no “rejection” of contact lenses an an immunoreacative even and, in the event and, in the event that a similar phenomenology should arise, a different application management could be decisive. Our approach to contactology is based on the most recent studies on the subject and on a consolidated experience that has allowed us to manage even the most delicate cases so far. For this reason Stecca Optometry has equipped it studios with the most recent instructioms and avails itself of the advices of specialists in the sector. We also cooperate with specialist contact lenses producers that spends important resources to the research of materisl taht are increasingly biocompatible with ocular physiology.

The patient management process includes an initial in-depth visit thru an appointment, which will then be followed by a series of control visits that vary according to the needs of the case. It is also important to have information on vision, comfort, foreign body sensation and symptoms of dryness at each visit. At each visit, the following will be performed:

THE COMPLETE EXAMINATION OF VISUAL ACUITY

THE EXAMINATION OF SUBJECTIVE OVER-REFRACTION

THE EXAMINATION OF THE CORNEAL TOPOGRAPHY

IN-DEPTH CONTROL OF THE CONTACT LENSES

THE EXAMINATION OF THE FLUORESCEIN PATTERN

THE EXAMINATION IN A SLIT LAMP WITH AND WITHOUT THE CONTACT LENSES

Once the first trails contact lens has been chosen and used a few hours, methodological analysis of the contact lens in use will be performed at a later time, adopting a clinical approach with annotation of symptoms, identification of signs and the chouse of the most appropriate solution. Any problems resulting from the use of a contact lens can be summarized in optical, mechanical, metabolic and hydration, allergic, toxic or infectious, tissue problems.

CORNEAL TOPOGRAPHY

Stecca Optometry performs computerized analysis of the cornea, designed to define the exact geometry for the best application of contact lenses and for optimal performance.

ADVANCED CONTACTOLOGY

The new knowledge of aberrometry and topography has led us to new contact lens fitting techniques, which are increasingly effective and comfortable.

Which contact lenses are called specialist?

CUSTOM SOFT CONTACT LENSES OR THICKNESS

The soft lenses or soft custom made, have the classic advantages of a soft contact lens: practicality and better comfort than rigid contract lenses. These lenses are available with base curves and customized diameters, to better adatp to the central area of the corena and to follow its eccentricity. Furthermore, in thickened soft contact lenses, the central thickness increases, compated to classic soft contact lenses, to try to hide the irregularity of the cornea as much as possible. The disadvnatages are the inability to correct irregular astigmatism and the low oxygen permeability, typical of silicone hydrogel lenses, even if big steps forward in this direction has been made by the manufacturers who now allow the long wearing of the soft contact lenses with satisfactory comfort.

RIGID GAS PERMEABLE CONTACT LENSES (RGP)

Another type of solution are the rigid gas permeable contact lenses with diameters generally comprised between 8 mm and 15 mm; this type of lenses are available with different types of geometry and with customizable parameters, suitable whenever the patient does not reach full satisfaction with a soft one. The advantages are given by the ability of the lens to ensure a regular optical surface that masks the irregularity of the underlying cornea and ensure good tear exchange under the lens. The disadvantages mainly concern the patient’s difficulty in adapting.

PIGGYBACK APPLICATIONS

In situation where initial comfort with a semi-rigid lens is poor and it is difficult to achieve good centering, a solution is the piggyback system. The system traditionally involves the use of a soft lens on the surface of which a flare is made into which the rigid lens is inserted. It is a system particularly suitable also in cases of epithelial fragility. The advantages of piggyback application are to ensure the comfort of a soft lens with the visual quality of RGP lenses and at the same time reduce corneal complications and oxygen deficiency. The disadvantages are obviously given by the management of two types of lenses, with the relative difficulties in maintaining them.

MINI-SCLERAL AND SCLERAL CONTACT LENSES

In cases where contact lenses centering is difficult or you want to ensure high optical quality while respecting the epithelial structure, you can opt for the application of larger RGP lenses. Diameters between 15mm and 18mm can be considered mini-scleral, while diameters from 18mm to over 24mm are considered scleral. These lenses today represent an excellent corrective solution for all irregular corneas, which have dystrophies, which have suffered trauma or which have been treated with corneal surgery. The application of these lenses requires knowledge of the profile of the corneo-scleral junction and scleral topography. They are designed to achieve alignment and stabilization on the scleral conjunctiva and lifting on the cornea. Since part of the tear fluid remains under the contact lens in these applications, they can also have a therapeutic effect, as well as masking very large areas of corneal irregularity. They also offer better comfort and optical quality.

COSMETIC PROSTHETIC CONTACT LENSES

KERATOCONUS

Keratoconus is a corneal dystrophy that is considered by the Ministry of Health as a rare disease. In fact, among the many eye diseases that can compromise visual health, keratoconus has a very bad psychological impact on the patient who is affected by a degenerative process that does not heal, but that can only get worse. So we are talking about an extremely long-lasting disease that mainly afflicts people at a young age. The first point of reference for a patient suspected of keratoconus is often the optometrist. In fact, the initial symptoms of the disease that lead to a more in-depth investigation are usually visual manifestations. The disease generally begins with severe itching of the eyes accompanied by ocular redness; however, as these symptoms are of low specificity and are associated most of the time with secondary ocular pathologies, they are very often overlooked. Instead, it is the typical symptoms of visual defects that play a fundamental role: blurred vision and poor visual acuity with glasses are the most frequent symptoms. The optometrist’s task is therefore to perform an accurate eye exam to certify the patient’s visual abilities; usually the disease involves an increase in myopia accompanied by oblique astigmatism already in the early stages. Another clue, useful in the construction of the suspected keratoconus picture, is the high and anomalous frequency of refractive variation with obviously equally frequent needs to change glasses.