After checking vision and a few external tests, a glasses prescription was attempted. However, this patient’s responses were all over the place and highly inconsistent from one click to the next. Anterior segment imaging was performed as well as slit lamp examination and there was significant cornea warpage found from chronic wear of the RGPs. This means the cornea was actually irregularly bent which was causing the inconsistent responses. Additionally, on slit lamp examination, there was a large nodule on the left cornea. You can think of this as a callus that developed adjacent to where his lens was sitting on his eye.

After discussing the findings with the patient and referring the ophthalmologist, we recommended discontinuing the use of the RGPs and to be fit with scleral lenses instead.