The correction of a hyperopic astigmatism with full-toric orthokeratology lenses. Clinical case

Abstract

Orthokeratology has gained widespread clinical application in the last decade due to accumulated scientifi c data confi rming its effectiveness in inhibiting progressive myopia in children and adolescents. In cases of correction of other refractive errors, such as hypermetropia, mixed astigmatism, specialists inform patients about the possibilities of orthokeratology lenses (OKL) not often. This clinical case demonstrates the possibilities of customized, full-toric OKL to correct complex hyperopic astigmatism in an 11-year-old child. The patient was observed for several years with complex hyperopic astigmatism in ophthalmological clinics and followed the recommendations of specialists to use eyeglass correction. At the stage of transition from preschool to primary school, the child became shy of glasses and refused to wear them. In search of an alternative method of correction, parents sought advice in the special contact lens practice. The patient underwent a complete ophthalmological examination, including corneal topography. Taking into account the features of refraction and the shape of the cornea, the wishes of the child and parents, we have chosen customized orthokeratology lenses (OKL) with a fully toric design (full-toric) as method of correction. The OKL parameters were calculated by using the RGP Designer program. The lenses were made by OKVision Laboratory (Moscow). The fi tting of customized OKL allowed us to solve several tasks at once: the correction of complex hyperopic astigmatism and the freedom from using correction tools in the daytime. Despite the fact that orthokeratology is not the fi rst-line choice for optical correction of hyperopia, in some cases the method may become the only alternative to glasses and soft contact lenses