Contact Lens Fitting Trouble Shooter

 

Trouble Shooter for Rigid Lenses (Objective Findings)

OBJECTIVE FINDINGS

PROBABLE CAUSE

CORRECTION

Bubbles under lens.

Lens too steep or large.

Flatten BC or Reduce OD

Central touch.

Lens too flat.

Steepen BC

Central pooling with ring touch.

B.C. too steep.

Flatten BC

Deep corneal stain with pain.

Corneal ulcer Possible uveitis..

Discontinue lens wear. Medical care required.

Excessive edge standoff

Peripheral curve too Flat or wide.

New lens with narrower and/or steeper PC

Excessive movement.

Lens too flat or steep.

Excessive tearing.

Check fluorescein pattern and lens edge.

Fine stipple.

Normal in adaptation if not inadequate circulation.

Flatten BC or reduce OZ Clean lenses.

Fluorescein “H” pattern.

Corneal astigmatism.

Toric lens required.

Lens displaced by lid.

Lens too large or flat or edge too thick.

Reduce OD. Steepen BC. Reduce ET.

Lens falls out.

Lens too small or flat.

Larger or steeper lens.

Lens rides to side.

Against rule astigmatism

Steepen PC and reduce OZ

Or toric base required.

Lens rides under upper lid.

Lens too flat. Too flat anterior curve.

Reduce OD & Steepen BC. Use lenticular lens.

Lens rides too low.

Lens too small or flat or thick.

Reduce CT. Steepen BC. Use lenticular lens.

Lens shows no movement.

Lens too large and/or steep.

Flatten BC or reduce OD.

Mucus on lens.

Scratched surface encouraging deposition.

Polish lens. Use enzyme cleaning to prevent build up.

Stain 3 & 9 O’clock.

Too flat PC. Improper size.

Steepen SC. Flatten BC or alter OD.

Zig-Zag corneal stain.

Foreign body under lens.

Discontinue wearing for a short period. Clean lens.