A Guide to Clinical Contact Lens Management

Signs, Symptoms, Diagnosis and Management

Academy for Eyecare Excellence™
IN COOPERATION WITH
Centre for Contact Lens Research
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Contact lens defect

Video: Contact Lens Misfitting - Inside-Out Soft Lens

Contact Lens Misfitting - Inside-Out Soft Lens

Video: Contact Lens Misfitting - Very Loose Inferior Positioned Soft Lens

Contact Lens Misfitting - Very Loose Inferior Positioned Soft Lens

Lens Misfitting - Soft

Decentration, excess movement, immobile lens

Symptoms

  • Excessive lens awareness
  • Visual fluctuation
  • Other (typically inflammatory) complications in cases of a marked lack of lens movement

Signs

  • Decentered lens
  • Immobile or excessively mobile lens
  • Lens edge lift or “fluting”
  • Edge indentation viewed by fluorescein in cases of excessive tightness

Etiology

  • Inappropriate soft lens parameters (diameter and radius) for optimal centration and movement
  • Can arise due to lens being inserted inside out

Prevalence

  • Fairly common

Differential Diagnosis

Management

  • Altering base curve has more effect on lens centration than movement for ultrathin lenses
  • Excess movement - allow for lens settling, increase diameter, decrease lens thickness, steepen base curve
  • Insufficient movement - allow for lens settling, decrease diameter, flatten base curve, or refit with different lens design
  • Decentration - increase diameter, steepen base curve or refit with different lens design
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