This article is a technical communication article provided by Nanjing Gulou Ningyi Ophthalmic Center. Please note: this case is special and not suitable for routine reference.

In early May, a female patient in Gulou Ningyi Ophthalmic Center gave up laser surgery because of her special needs to improve her naked eye vision the next day.

After inspection, the basic information is as follows:

Uncorrected visual acuity: R: 0.08, l: 0.08

Computer optometry: R: - 5.50 / - 0.75 * 20, l: - 5.25 / - 1.25 * 175

Retinoscopy: R: - 5.50 / - 0.50 * 20 = 1.0, l: - 5.25 / - 1.00 * 175 = 1.0

Corneal curvature: R: HK: 45.00, VK: 46.00, l: HK: 45.00, VK: 46.50

The visual acuity was 0.6 (4.8). Considering that the patient's physical examination time is the next day, it is too late to do laser surgery. Based on various reasons, it is suggested that the lady choose orthokeratology lens, and it is possible to meet her needs the next day.

Introduction to the trial wearing process:

According to the above parameters, the standard lenses R: 4450 / 500, l: 4450 / 450 were selected for the first time.

After 20 minutes, both eyes were stained

R: The position was in the middle, the range of motion was 1.5-2 mm, each arc of staining was clear, and the visual acuity of wearing glasses was 1.0 -.

50: The location was in the middle, the range of motion was 2-2.5mm, the staining arc was clear, the positioning arc was thick green, and the vision of wearing glasses was 1.0 -.

Left eye lens exchange 4450 / 450 > 4500 / 450

Staining evaluation: the localization was partial to the temporal side, the range of motion was 1.5-2 mm, the staining arc segments were clear, and the visual acuity of wearing glasses was 1.0.

Selection of lens parameters:

R：4500/500 L：4500/450

Because the time is very short, if according to the previous fitting experience, the degree is too high, the appropriate tightness is appropriate or even slightly loose, the vision of the next day may be slightly worse, so choose the lens with tight fitting.

Today, the woman just called and said she met her vision requirements. So I will write down this case to communicate with you.

Case summary:

It is not easy for such a high myopia degree to restore naked eye vision to 0.6 the next day, but in this case, there are several matters needing attention, I will summarize here.

1. Excluding the contraindications of orthokeratology, the woman's corneal curvature is still relatively high. The expected shaping effect is also ideal. (you can also refer to the E value on the corneal topography map, of course)

2. Those who have requirements for improving their uncorrected visual acuity must let them know the expected effect and limitations of plastic lenses. Although it can provide a non-surgical method to improve vision for patients, it does not guarantee that they will pass the physical examination. If they are willing to accept it, they can try.

3. Such a tight fit can only temporarily improve naked eye vision, and lenses can not be used for a long time.