Contact Lens Fitting Research Articles

A proposed methodology for conducting a remote rigid gas permeable contact lens consultation

PurposeCOVID-19 spread to numerous countries, overwhelming healthcare systems and economies worldwide. COVID-19 restrictions have prevented patients from attending consultations in person and led to the further development of telemedicine to provide health care. The situation also applies to contact lens (CL) practitioners and their patients; telemedicine enables practitioners to provide patients with regular and continuing care. This study aimed to investigate available tools to enable continuing care for rigid gas permeable (RGP) CL wearers who are unable to attend face-to-face consultations. MethodsThe study consists of three components. Firstly, an approach to enable the assessment of a patient’s CL fitting and cornea remotely. Secondly, to find an affordable and reliable method to obtain a patient’s visual acuity (VA), and thirdly, to develop a questionnaire to provide practitioners with information to deliver optimal patient care. ResultsThe use of a macro lens, smartphone, and auxiliary materials enables high-quality images of the anterior eye and RGP CL to be obtained. Two free and validated smartphone applications (apps) for VA measurements were identified which are available on Android and iOS systems. Two questionnaires were also developed to enable practitioners to obtain additional patient information to facilitate optimal patient care. ConclusionThis study has developed the components of a remote CL consultation to enable patients who cannot attend scheduled appointments to receive care and advice to ensure the safety of their RGP CL wear. The tools involved in this study are low-cost, affordable, and an adjunct, not a substitute, for face-to-face consultations.

Soft contact lens options in the management of pediatric aphakia – A quantitative and qualitative assessment

BackgroundThe main contact lens for pediatric aphakia has historically been a silicone elastomer lens (Silsoft SuperPlus). Due to supply chain disruption, many aphakic children required an alternative lens. We performed quantitative and qualitative comparisons between Silsoft SuperPlus and alternative aphakic soft contacts. MethodSixty-nine aphakic eyes of 49 patients wearing Silsoft SuperPlus lenses underwent the refitting process into an alternative soft contact. Data collected included lens parameters, visual acuity, keratometry, horizontal visible iris diameter, and over-refraction. A 6-question survey assessing the patients’/guardians’ experience with Silsoft SuperPlus versus the alternative lens was conducted at initial fit and 1–3 months post-fit. ResultsTwenty-four patients (49 %), 4(8 %), and 1(2 %) were refit into Flexlens Definitive 74, Biofinity XR, and Intelliwave Pro Toric lenses, respectively. Sixteen patients (34 %) remained in Silsoft SuperPlus due to personal lens surplus or inability to handle the new lens while 2(4 %) opted for glasses. Silsoft SuperPlus was typically successful in eyes with average keratometry (AveK) 7.4–7.6 mm. Flexlens Definitive 74 required a base curve 0.4 mm steeper than the AveK. Patients’/guardias' reported a trend toward greater comfort with handling Silsoft SuperPlus, however, patients experienced less adverse side effects with the alternative soft contact lenses. ConclusionsFlexlens Definitive 74 was an adequate alternative to Silsoft SuperPlus in aphakic children, however lens parameters must be steepened. Keratometry streamlined the contact lens fitting process. Alternative soft lenses are a cost-effective alternative to Silsoft contact lenses.

Retracted: Effects of Medium-Term Soft Contact Lens Fitting on Dry Eye: Analyses Using Ultra-High Resolution Optical Coherence Tomography and Digital Slit-Lamp Biomicroscopy.

[This retracts the article DOI: 10.1155/2022/7220706.].

Functional visual tests to evaluate the effect of small astigmatism correction with toric contact lenses.

The prescription of daily contact lenses does not often include a full astigmatic correction. We question here whether this full astigmatic correction (for low to moderate astigmatism) provides a substantial improvement in the overall visual performance compared to a more conservative approach based only on the prescription of spherical contact lenses. The visual performance of 56 contact lens neophytes divided in two contact lens fitting groups (toric versus spherical lens fit) was assessed using standard visual acuity and contrast sensitivity tests. A new set of functional tests simulating everyday tasks was also used. Results showed that subjects with toric lenses had significantly better visual acuity and contrast sensitivity than those with spherical lenses. Functional tests did not render significant differences between groups, which was explained by several factors like i) the visual demand of the functional tests, ii) the dynamic blur due to misalignments and iii) small misfits between the available and measured axis of the astigmatic contact lens.

Comparing sagittal heights calculated using corneal parameters and those measured with profilometry.

To compare the sagittal height of the anterior eye (OC-SAG) calculated using corneal parameters with the OC-SAG measured by profilometry. Seventy right eyes of soft contact lens wearers measured with the ESP (Eaglet Eye, The Netherlands) after lens removal were retrospectively analyzed for this study. The OC-SAG of the eyes was calculated using mean k-values, eccentricity and the inner (corneal) radius obtained with the ESP for an 11-mm cord diameter. It was then extrapolated to chord diameters of 14, 14.5 and 15mm. These values were compared with OC-SAG values obtained with the ESP for the same chord diameters. Additionally, the OC-SAG was calculated through the formula used by a lab that manufactures custom soft lenses (mark'ennovy, Madrid, Spain) and compared again with the values obtained using the ESP. Differences between calculated OC-SAG obviating the shape factor were 121±44, 155±105, 172±117 and 189±129µm for chord diameters of 11, 14, 14.5 and 15mm, respectively (p<0.001). When the shape factor was included in the calculation, differences were 28±48, 62±102, 79±113 and 96±123µm (p<0.001). When the inner best fit sphere was used to estimate OC-SAG, differences were 34±11, 0±72, 17±86 and 34±99, respectively, with no significant differences for the 14 and 14.5mm-chord diameters (p=0.99 and 0.11, respectively). Correlation coefficients between OC-SAG calculated and measured OC-SAG ranged from 0.53 to 0.90 depending on the chord diameter used. When the mark'ennovy formula was used to calculate the OC-SAG as the lens diameter proposed by the formula, the difference was -47±147µm (p<0.01). Differences between the OC-SAG calculated using corneal parameters and that measured with a profilometer are statistically and clinically significant, especially for large chord diameters. The impact of this on contact lens fitting should be addressed in future studies.

Guide and tools for comprehensive toric soft contact lens fitting

Contact lens options for astigmatic patients include commercially available toric soft contact lenses, custom soft contact lenses, rigid corneal and scleral contact lenses. Wide range of parameters and modalities of modern soft toric lenses covers more than 90 % of patients with astigmatism. It makes toric soft contact lenses most available and convenient option for eyecare specialists.Purpose of this publication is to review main steps of toric lens fitting and remind ECP about useful tools and services designed to reduce chair time.

RGP-Kontaktlinsen, Netzhautforamen und Aderhautnävus

Purpose. The case report describes the management of a retinal hole and two choroidal nevi during RGP contact lens fitting. Material and Methods. During a comprehensive eye exami- nation as part of a contact lens fitting, a retinal hole and two choroidal nevi were detected in the patient’s right eye by in- direct ophthalmoscopy and Optomap ultra-widefield imaging (Optos Daytona Plus). The preoperative and postoperative findings and optometric/ophthalmological co-management are described. Results. The retinal hole was completely closed by laser coagulation. The suspected diagnosis of two choroidal nevi was confirmed. Conclusion. Myopia in particular is often associated with secondary retinal diseases. For this reason, regular retinal examinations are indicated in myopic patients. A full eye examination is normally recommended in the prescribtion of visual aids for those affected. Keywords Myopia, contact lenses, retinal foramen, choroidal nevus

Therapeutische Schutzverbandskontaktlinsen bei Blepharophimose-Ptosis- Epicanthus-inversus-Syndrom

Purpose. The case report describes the fitting of bandage contact lenses for bilateral severe visual impairment, severe ocular pain and glare sensitivity and the rehabilitative effect on the life of the affected patient. Material and Methods. Structured fitting of silicone hydro- gel bandage contact lenses and visual rehabilitation in a 49-year-old female patient with bilateral blepharophimo- sis-ptosis-epicanthus-inversus syndrome (BPES) and neu- trophilic ulceration bilaterally, as a result of lagophthalmos in marked incomplete blink OD and nearly inactive eyelids OS and bilateral ptosis. Results. By means of structured and targeted fitting of phys- iologically acceptable bandage contact lenses in continuous wear modality, almost all limiting visual and pathophysiological symptoms of the patient such as glare sensitivity and pain could be eliminated. The corrected visual acuity could be increased from light perception to 1.0−2. The patient again participates regularly in normal work and leisure life and is fully reintegrated into society. Conclusion. Bandage contact lenses are used in daily clinical practice. A goal oriented fitting procedure often allows a com- plete visual and social rehabilitation even in severe cases. The field of application is multifarious, and the patients concerned are very grateful for the rapid and uncomplicated help. Keywords blepharophimosis-ptosis-epicanthus-inversus syndrome, bandage contact lens, rehabilitation

Scleral Contact Lens for Steven-Johnson Syndrome

Background: Steven-Johnson syndrome is one of life-threatening skin abnormality. SJS complication involve multiorgan disfunction such as mucosa, ocular, respiration, and digestive tract. Around 30- 50% of SJS patient experience chronic ocular sequel, which concludes progressive symblepharon, margo palpebral keratinization, trichiasis, entropion, corneal pannus, dry eye syndrome, and persistent epithelial cornea defect. Scleral contact lenses has beneficial in managing SJS patient, on both acute and chronic phases. Methods: A 36-year-old female patient with SJS, presented for eye examination due to unpleasant sensation on both of their eyes and unsatisfactory quality of her vision. She presented high myopia, margo palpebral keratinization with trichiasis and distichiasis, symblepharon and hyperemic conjunctiva, wide corneal scar, and ocular neovascularization. A diagnostic trial set was used in the fitting process, and she was assessed according to standardized fitting methodology. Visual acuity, corneal topography, biometry, and ocular aberrations were evaluated. The follow-up period was 12 months. Results: The best corrected visual acuity was 20/60 with correction lens S – 1.00 D for the left eye (LE) and 20/25 cannot be corrected with correction lens for the right eye (RE). After corneal contact lens fitting, visual acuity was improved to 20/20 and 20/25 for the RE and LE, respectively. The patient wore these contact lenses an average 8 hours a day. The patient’s dry eye complaint was significantly decrease with more comfortable ocular sensation Conclusion: The present case report describes how the patient had scleral contact lens fitted successfully for management of SJS ocular complication. They provided optimal visual quality and restore the patient’s comfort.

Kontaktlinsenhygiene ein Literatur-Review

Purpose. Contact lens hygiene is a crucial factor for a success- ful contact lens fitting and, above all, for long-term healthy contact lens wear. A review of the literature is intended to summarize the most important points especially in relation to recent publications. Material and Methods. A narrative literature review was performed to identify relevant publications. PubMed (www. pubmed.gov) was used as the platform for the search. The search term used was “contact lens hygiene”. Results. Successful contact lens hygiene depends on the effectiveness of the care solution, the instruction of the pa- tient by the contact lens practitioner and the correct imple- mentation of the recommended care steps. Basically, either multipurpose solutions (combination solutions) or peroxide systems are available for care. The advantage of peroxide systems is the higher disinfection performance compared to multipurpose solutions. For rigid gas permeable contact lenses, manual surface cleaning in combination with a surface cleaner is essential. The likelihood of occurrence of microbial keratitis is lower in wearers of rigid gas permeable contact lenses than in wearers of soft contact lenses. Conclusion. In addition, to hand hygiene, the selection of the care product and regular instruction of the user by the eye care practitioner play a vital role. From a hygienic perspective, daily disposable contact lenses are the safest option. Keywords Contact lens hygiene, contact lens compliance, contact lens storage case, microbial keratitis, RGP contact lenses, soft contact lenses

The Comparison of Soft HydroCone (Toris K) Silicone Hydrogel and Rigid Gas-Permeable Contact Lenses in Patients With Posterior Microphthalmos.

To evaluate and compare soft HydroCone (Toris K) silicone hydrogel and rigid gas-permeable contact lenses (RGPCLs) in patients with posterior microphthalmos (PMs), for visual rehabilitation and comfort. The records of 11 patients who were followed up in our hospital with the diagnosis of PM and were fitted with both Toris K and RGPCLs in our contact lens department were reviewed retrospectively. Patient age, gender, axial length (AL), topographic keratometry (K) values and best-corrected visual acuity (BCVA) with both lens types and subjective lens comfort status were recorded. A total of 22 eyes of 11 patients with a mean age of 20.9±11.1 years were included in the study. The mean AL were 16.01±0.1 and 15.9±0.2 mm in the right and left eyes, respectively. Mean K1 and K2 were 48.6±2.2 and 49.4±2.2 D, respectively. Mean logMAR BCVA of the 22 eyes before contact lens fitting was 0.63±0.56 with spectacle. After Toris K and RGPCLs fitting, mean logMAR BCVA were 0.43±0.20 and 0.35±0.25, respectively. Both lenses provided better visual acuity than spectacles; RGPCLs also provided significantly better visual acuity than HydroCone lens ( P <0.05). Eight of 11 patients (73%) had ocular discomfort with RGPLs, and there was no complaint with Toris K. The corneal surfaces are steeper in patients with PMs than in normal population. For that reason, their vision should be rehabilitated by special design keratoconus lenses like Toris K and RGPCLs. Although vision rehabilitation seems better with RGPCLs, these patients prefer Toris K more because of discomfort.

Clinical experience with adjustable scleral lenses.

The aim of this study was to evaluate the fitting process of a scleral lens that allows several parameter adjustments during trials and after the initial period of use. In addition, we verified which adjustments were needed and used the most, their indications, and how often these resources were used, and checked the results. Scleral contact lens fittings in a private clinic setting were prospectively analyzed in a sequential, non-randomized, and non-comparative manner. All the patients underwent a complete ophthalmic examination and had an indication for scleral lens use (Zenlens, Alden Optical). Scleral fit was analyzed in 80 eyes of 45 patients. Regarding diagnosis, 72% of the patients had keratoconus; 12%, radial keratotomy; 5%, post-refractive surgery ectasia; 5%, dry eye; and 3%, high myopia. In 66 (82.5%) of the 80 eyes studied, parameters were modified when the lenses were ordered. The reasons that led to the modifications were apical touch or decreased sagittal height, increased sagittal height, cylindrical over-refraction, poor visual acuity, lens flexure, peripheral touch, 360° edge compression, horizontal edge compression, and vertical edge compression. In this study, the use of Zenlens scleral lenses was shown to be a promising corrective treatment for patients requiring the use of scleral lenses. Although the study suggests a learning curve, as many adjustments were allowed, the lens could be customized according to the patients' needs. This increased the success rates of fitting and wearing, and consequently, use of the lens became a great option for the visual rehabilitation of patients.

Keratoconus: main lines of research

Keratoconus (KC) research focuses on studying pathogenesis, advancing diagnostic techniques and methods of correction and treatment. The working hypothesis for KC etiopathogenesis is based on abnormalities in distribution of microelements in the cornea and its potential influence on the processes of stromal collagen disorganization. Improvement of early diagnosis of KC is associated with evaluation of microstructural changes in the cornea using computerized methods such as Scheimpflug camera and high-definition optical methods for visualization of initial signs of a pigment ring. The main optimization directions of KC contact correction are associated with increasing gas permeability of the material, improving lens design and methods of lens fitting. Customized fitting of gas-permeable scleral hard contact lenses with consideration of topographic features of the anterior corneal surface allows achieving stable lens positioning and preserving the tear gap between the lens and the cornea. Alternative methods of correcting the refraction component of KC are associated with surgical interventions involving increase in corneal volume in the paracentral area. Implantation of corneal ring segments should be considered as an alternative to correction of refractive errors in cases with unsatisfactory individual subjective tolerance and insufficient patient compliance with contact correction. Femtolaser-assisted implantation of intrastromal allotransplants along with a decrease in the degree of spherical and astigmatic components of refractive errors contribute to prevention of KC progression. Advancement of techniques of corneal collagen cross-linking for prevention of KC progression is aimed at reducing the risk of developing post-operative complications directly related to the extent of intraoperative deepithelization. Limiting corneal ectatic area by implantation of intrastromal allotransplants can be considered an alternative approach. Deep anterior lamellar keratoplasty and penetrating keratoplasty are the surgeries of choice in replacing altered corneal layers in KC. With regard to the modern trends in selective keratoplasty, selective replacement of the cornea in lamellar keratoplasty reduces the rate of injuries and the risk of tissue reaction.

Online survey about keratoconus management by optometrists.

The aim of the study was to survey keratoconus management by optometrists in India. A validated online survey questionnaire was circulated to all optometrists from India who had completed 4 years of optometry programs. Practitioners were asked general contact lens practice questions and keratoconus management-related questions. For analysis, data were imported into SPSS (IBM Corp. 2011). A total of 159 optometrists responded to the questionnaire, of whom 10.7% of practitioners had >10 years of experience and the remaining 89.3% had <10 years. Only 45.3% of respondents had corneal topography in their practice. Approximately 55% of practitioners prescribed gas permeable (GP) lenses. Around 77.4% of practitioners considered that a combination of multiple factors is necessary for keratoconus investigations. In addition, 91.8% of practitioners used the keratoconus severity classification. Also, 73% of practitioners consider that GP contact lens (CL) fitting is more difficult in keratoconic eyes than in healthy eyes. The average number of GP diagnostic lenses used in keratoconus CL fittings was 3.93 ± 1.92. A majority of practitioners calculate back optic zone radius (BOZR) using the manufacturer's guidelines (based on manual keratometry [39.6%] or based on corneal topography [40.3%]). Around 40.3% of respondents prefer to refer patients to another optometrist for CL fitting before consulting an ophthalmologist for surgical intervention. Finally, half of the respondents participate in co-management with ophthalmologists after surgical treatment (54.1%). This study provides details about the management of keratoconus by optometrists in India. Keratoconus patient care could be improved with new evidence-based guidelines for the management and referral of these patients that would provide guidance on GP CL fitting procedures. Furthermore, it determines referral criteria and enhances co-management between optometrists and ophthalmologists.

Why are soft contact lens wear discontinuation rates still too high?

ABSTRACT Introduction Notwithstanding continuing improvements in contact lens technology and increasing use of daily disposables, discontinuations from soft contact lens wear remain a significant problem with ‘drop-out’ too often occurring after patients have initially achieved successful routine use. Areas covered This review examines the possibility that the signs and symptoms of discontinuations might, for example be associated with corneal and/or lid wiper neuropathy and/or aqueous, mucin and lipid deficiencies and/or mental health disorders. In addition, this review examines how soft contact lens wear places high demands on tear functions. Expert opinion Limitations in clinically detecting evidence of some adverse responses to soft contact lens wear may explain how discontinuations can sometimes be described as unexplained. Similarly, limitations in clinically determining the significance of different forms of tear dysfunction and their exacerbation by soft contact lens wear may be a barrier to explaining why symptoms of dryness are most commonly associated with discontinuations. The wider experience obtained with cosmetic contact lens fittings that is discussed in this review may be relevant to problems encountered in therapeutic contact lens applications.

Self-reported knowledge and skills related to diagnosis and management of keratoconus among public sector optometrists in the Limpopo province, South Africa

Keratoconus (KC) has been regarded as a rare condition, although recent studies, including those in South Africa, suggest it is common and is increasing in prevalence. Furthermore, South African-based studies have shown that KC is normally detected at advanced or severe stages. Knowledge and skills for examination, diagnosis and management of KC by optometrists are important for the early detection and management of the disease. This study aimed to evaluate self-reported knowledge and skills for examination, diagnosis and management of KC patients among public sector optometrists. Seven public hospitals of the Capricorn district of the Limpopo province, South Africa. A quantitative cross-sectional descriptive study design was used. A self-administered online questionnaire was used to collect data on demographic characteristics of participants and their knowledge, skills and practice for the diagnosis and management of KC. Twenty-four optometrists (n = 24) with a mean age of 39 ± 5.67 years, 18 (75%) of whom were female, participated in the study. Nineteen (79%) reported that their hospitals did not have the appropriate equipment to examine, diagnose and manage KC patients. Lack of equipment, poor knowledge, skills and competencies, hospital's level of services, policy and lack of interest were cited as barriers to contact lens fittings in KC patients. Using a dichotomised summation of self-reported knowledge and skills of KC, 13 (54.2%) of the optometrists were knowledgeable and skilled on risk factors of KC and examining, diagnosing and managing KC patients. A significant proportion of optometrists did not have the appropriate knowledge and skills to examine, diagnose and manage KC patients. Lack of equipment and poor knowledge and skills were the main barriers to contact lens fittings in managing KC.Contribution: This article highlights the need for the district to upskill the optometrists through a structured programme with a theory and practical component and also provide the necessary equipment to enhance patient care.

Dupilumab-Induced, Tralokinumab-Induced, and Belantamab Mafodotin-Induced Adverse Ocular Events-Incidence, Etiology, and Management.

Emerging monoclonal antibody therapies are assuming greater importance in the management of severe and refractory forms of immunity-driven and oncological disorders. However, some have been found to induce adverse ocular events (AOEs) leading to discontinuation of treatment or additional multidisciplinary management. We present the current knowledge concerning AOEs associated with 3 monoclonal antibody therapies: dupilumab, tralokinumab, and belantamab mafodotin. We examine the manifestations of their AOEs, proposed pathophysiological mechanisms, and current treatment recommendations. We identified and reviewed all studies for dupilumab, tralokinumab, and belantamab mafodotin using the keywords "dupilumab," "tralokinumab," "belantamab mafodotin," "conjunctivitis," and "keratopathy" from January 2016 to November 2021. Conjunctivitis was the most frequently reported AOE in patients with atopic dermatitis receiving dupilumab or tralokinumab. Mild cases were managed with warm compresses for associated meibomian gland dysfunction, artificial tears, and antihistamine/mast cell stabilizer eye drops. In more severe cases, additional anti-inflammatory therapy, with corticosteroid eye drops or ointments, or topical calcineurin inhibitors-such as tacrolimus or ciclosporin-were required. Patients with resistant or refractory multiple myeloma treated with belantamab mafodotin often developed keratopathy, which could necessitate contact lens fitting, or for cycles of belantamab mafodotin to be delayed.

Corneal curvature and thickness – Scheimpflug

AbstractAlthough the Scheimpflug principle was first described over a century ago, the clinical use of Scheimpflug camera in anterior segment imaging started only a decade ago. Scheimpflug imaging has since advanced significantly and modern instruments provide comprehensive imaging and topographic data of the anterior segment using a noncontact method. It provides anterior and posterior surface topography of the cornea that is derived from true elevation measurements. Approximately 25 000 data points are used to calculate topographic corneal thickness, corneal curvature, anterior chamber angle, volume, and height. Pachymetry and topography of the entire anterior and posterior surface of the cornea from limbus to limbus are calculated and displayed. Keratoconus detection maps may be generated to assist in the classification and diagnosis of keratoconus prior to contact lens fitting or refractive surgery. Zernike wavefront representation of the anterior and posterior surface of the cornea may be calculated based on the measured height data. In this presentation the clinical applications and limitations of Scheimpflug imaging will also be discussed.

Corneal RGP Contact Lens Fitting Software for Keratoconus Built-In Anterior Segment Optical Coherence Tomography.

To assess the performance of the contact lens fitting software built into anterior segment optical coherence tomography (AS-OCT). This retrospective study enrolled patients with keratoconus prescribed with spherical corneal rigid gas-permeable contact lenses based on a contact lens fitting software. Subjects were classified into four subgroups based on corneal morphology: nipple, oval, globus, and marginal type. Software performance was evaluated according to the correlation between the back optical zone radius (BOZR) calculated by the contact lens fitting program and the BOZR of the lens prescribed, and the number of trial lens replacements required.Results:A total of 340 eyes of 254 patients with a mean age of 40.4 ± 13.6 years were included. The oval type was the most common (61.8%), followed by the nipple type (26.2%). Linear regression analysis revealed a significant correlation between the prescribed and the calculated BOZR in all subgroups (R 2 = 0.92, P < 0.01 for the nipple type; R 2 = 0.76, P < 0.01 for the oval type; R 2 = 0.93, P < 0.01 for the globus type; and R 2 = 0.79, P < 0.01 for the marginal type). Furthermore, the globus type had the highest proportion of cases requiring at least one trial lens replacement (36.3%), followed by the nipple group (27.0%). There were no significant differences among the subgroups ( P = 0.14). In conclusion, our findings reveal that the contact lens fitting software built into AS-OCT may be useful for accurate contact lens prescription for any corneal shape.

Rigid Gas Permeable Contact Lens Management of Infantile Aphakia Status-Post Cataract Extraction

Infants born with congenital cataracts require cataract extraction to prevent lifelong visual impairment resulting from deprivational amblyopia. After lensectomy, two optimal corrective treatment options exist: intraocular lens implantation or contact lens correction. This case presentation describes the etiology, treatment, and successful management of a patient with unilateral infantile aphakia with a rigid contact lens. The seven-week-old patient with a congenital cataract of the right eye was referred to our clinic for a contact lens fitting prior to cataract extraction. Surgeons often do not elect to manage aphakia with artificial lens implantation because the correct intraocular lens parameter is difficult to infer in a rapidly growing child, and surgical complications may occur. While glasses are important for when contact lens wear is not indicated, the high prescription required by these aphakic individuals results in significant visual distortion and aniseikonia. Contact lens correction has shown to be a safe and visually effective alternative to treating infantile aphakes. Various material options exist, including rigid gas permeable and soft lenses. While soft hydrogel lenses may appear more comfortable and less intimidating to a parent, limitations exist including restricted parameter availability for commercially produced lenses and reduced oxygen permeability for custom soft lenses. Rigid contact lenses provide optimal visual correction due to their extensive customizability while also offering high oxygen permeability. This lens modality, in conjunction with proper follow-up monitoring and ophthalmological co-management, provided for successful aphakia treatment in our patient. &lt;br&gt;CE Notification: This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll. (https://www.crojournal.com) Please check COPE course expiry date prior to enrollment. The COPE course test must be taken before the course expiry date.