MANAGEMENT OF INTRACTABLE DIPLOPIA WITH CONTACT LENSES: A CASE REPORT

Melnick Auditorium

Introduction. Management options for intractable diplopia include optical occlusion and frosted spectacle lens. The purpose of this case report is to explore the treatment of intractable diplopia with prosthetic contact lens occlusion and with plus power fogging techniques. Case presentation. A 67 year-old female patient was seen in July 2013 on referral from a tertiary eye care provider. Pertinent ocular history included LASIK, retinal detachment and repair and strabismus surgery. Best-corrected spectacle acuity was 20/50 OD and 20/25+ OS. The patient demonstrated an ocular deviation of 25 prism diopters constant right hypertropia and 8 prism diopters constant right esotropia. The patient was unable to achieve stable sensory fusion with relieving or neutralizing prism. The patient reported increased comfort when images were further apart and the non-dominant image was fogged. Fogging was introduced in one diopter increments over the distance Rx with the dispensed contact lens parameters as follows: omafilcon A, +4.50D, 8.60mm BCR and 14.2mm OAD. The parameters of the occlusion contact lens were as follows: hioxifilcon B, plano power, 8.9mm BCR, 14.5mm OAD, 4.0 mm black pupil and clear surround. Deviation From the Expected. Discussion. Conclusion. Upon first follow up, the patient reported benefits included improved cosmesis, slightly expanded binocular visual field and reversibility. Contact lens management with fogging or occlusion is a viable non-invasive treatment for intractable diplopia. Grants. None