Unilateral keratoconus and contact lens fitting

• —24 yo male
• Sniper in army – shoots off right shoulder and sights with right eye.
• —Unilateral keratoconic (20% of keratoconus)
• —Corneal Specialist referral – good time to riboflavin?
• —Monocular fit = flip lid / applanation tonometry.  The sensitivity test.

• OD: +2.00 / -2.25 x 88     (6/5=)
• OS: +0.50DS

Plan A

• SDTCL 8.7/14.0/+1.75/-1.75 x 90 (BLPVFA)
  • Rotationally unstable

Plan B

• RGP CL Correction
  • 7.40/14.0/C edge/-3.50 Boston XO (6/6+)
  • Rotationally symmetric RGP
  • No need for Front Surface Toric or asymmetric periphery