Ambylopia and Contacts

[Ryan_eyeball]

I had a question for all, or at least the current docs. Let's say you have a patient that is 15 years old or so. In high school worried about cosmetic appearance, and wants to get the cool boyfriend/girlfriend/ be popular whatever. They are OD -5.00 sph 20/20, but OS refractive amblyopic 20/80 best corrected VA, oh i guess OS -7.00. Would you be willing to fit them into a soft or RGP lens in the OD eye, and even OS?

The reason I ask is because would we be putting this patient in danger of harming their lives if they had blunt trauma to the OD eye. If say polycarbonate lenses only are prescribed, let say the trauma could have been avoided.

How would you handle the situation? Would you say firmly that you can only wear specs because of protection of the only good eye remaining? I was just wondering what others thought. I guess you could always put an occulder over the OD eye, and say that if the OD was damaged the 20/80 OS would be all that remained, and have them walk around a few minutes like that.

Thanks for sharing inputs.

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[LV2RIDE]

Just a personal opinion.......
I would make sure that the pt is completely informed about the situation and risks involved. My recommendation would be that the pt should only wear glasses with a trivex (polycarbonate) lens for best vision and protection of the OD. I would also make sure this is noted clearly in the pts records. I agree with the idea of letting the pt spend some time in the office with the occluder over the OD at least they would have an idea of what to expect if the OD was damaged. As far as fitting the pt into cls ultimately the decision should be up to the patient. Again just make sure you have made it clear as to what is recommend to the pt, and noted in the pt records (glasses with a trivex or poly material to correct vision and protect OD).

I had a question for all, or at least the current docs. Let's say you have a patient that is 15 years old or so. In high school worried about cosmetic appearance, and wants to get the cool boyfriend/girlfriend/ be popular whatever. They are OD -5.00 sph 20/20, but OS refractive amblyopic 20/80 best corrected VA, oh i guess OS -7.00. Would you be willing to fit them into a soft or RGP lens in the OD eye, and even OS?

The reason I ask is because would we be putting this patient in danger of harming their lives if they had blunt trauma to the OD eye. If say polycarbonate lenses only are prescribed, let say the trauma could have been avoided.

How would you handle the situation? Would you say firmly that you can only wear specs because of protection of the only good eye remaining? I was just wondering what others thought. I guess you could always put an occulder over the OD eye, and say that if the OD was damaged the 20/80 OS would be all that remained, and have them walk around a few minutes like that.

Thanks for sharing inputs.

 

[Idok]

I had a question for all, or at least the current docs. Let's say you have a patient that is 15 years old or so. In high school worried about cosmetic appearance, and wants to get the cool boyfriend/girlfriend/ be popular whatever. They are OD -5.00 sph 20/20, but OS refractive amblyopic 20/80 best corrected VA, oh i guess OS -7.00. Would you be willing to fit them into a soft or RGP lens in the OD eye, and even OS?

The reason I ask is because would we be putting this patient in danger of harming their lives if they had blunt trauma to the OD eye. If say polycarbonate lenses only are prescribed, let say the trauma could have been avoided.

How would you handle the situation? Would you say firmly that you can only wear specs because of protection of the only good eye remaining? I was just wondering what others thought. I guess you could always put an occulder over the OD eye, and say that if the OD was damaged the 20/80 OS would be all that remained, and have them walk around a few minutes like that.

Thanks for sharing inputs.

solid question..........happens ALL the time..

at 15, probably not.......too risky


at 18, yes.....but documentation and education is key....

 

[Opii]

Has this amblyope ever had patching done for the amblyopia? If not he might need to go though some patching. Although 15 yo may be late by some opinions, others say 1st time patchers even at this age may still benefit from patching.

 

[Ryan_eyeball]

Has this amblyope ever had patching done for the amblyopia? If not he might need to go though some patching. Although 15 yo may be late by some opinions, others say 1st time patchers even at this age may still benefit from patching.

it was just a hypothetical question. I wasn't really aiming at much vision therapy as much as concern for safety. I believe much of this lies in how much risk the patient wishes to accept if they choose contacts. Also, like others have said patient education about risks will be very important. Some drivers never wear a safety belt, and could never get in a car accident. Just goes back to how much risk a person is willing to take.