Extreme Dry Eye Secondary to Corneal Exposure – Thomas P. Arnold, OD, FSLS

Onefit Spotlight Case Report:

EXTREME DRY EYE SECONDARY TO CORNEAL EXPOSURE                                    Thomas P. Arnold, OD FSLS


65 y/o Caucasian female with exposure keratitis in the right eye following eyelid surgery for thyroid orbital disease. Previous strabismus SX for hypertropia. Type II diabetes and hypercholesterolemia.

Referred by MD for scleral lens fitting to improve vision and comfort.

Objective Findings/Subjective Comments

Current lenses:

OD: Onefit 15.2mm– 7.40 BC/70 CCR/-1.75–075 x 085/XLC/Flat 1/Flat 2

OS: monthly disposable soft toric

Manifest spectacle RX (2018):

OD -0.75 – 2.00 x 178   20/25

OS -1.25 – 0.75 X 027   20/20

SLE: Px improved but isolated SPK. Patient desires improved VA, comfort and longer hours of wear.

Dx Lens:

Onefit MED w/ Toric Haptics (TPC) 4600 sag / 16.0 Dia / -0.50 / Mid Peripheral Zone = Std / Limbal Zone = Std / TPC Landing Zone = +75/-75

Central clearance (OCT):  224 µm (30 minutes)

Over-refraction: +2.75, 20/20-

Toric Haptic Laser Etch (Hash mark indicates flatter meridian) – 110-115˚

SLE: lens slightly decentered inferiorly; too flat in both meridians

Read the full case report here: Extreme Dry Eye Secondary to Corneal Exposure_Arnold_5.14.20