CL for extreme aphake

I have a 20 yo woman coming my way with a spectacle Rx of ~+25D. In addition to having no experience with a refraction like this, I was thinking about CLs. (She's only been in glasses as far as I know.) I have not found anything close to her script in standard CLs, and am guessing she'll come in around 30-35D once she loses her vertex. Any idea where I might find a specialty house to do this? I'm sure her life would be a lot better with a more natural correction. Thx for the help!!

 

How long has she been aphakic?
(Cause? neonate cataracts?)
Has she been considered for or tried with implants (IOLs)? - ever? recently?

If only cls are indicated you can of course trial with the max normal ?+20D odd contacts and over refract: +6 odd spex is a huge improvement even if not a desired outcome.

Haptic contacts are a possibility for ad hoc power, but fitting etc is more tedious and experience people rare on the ground these days.

Might be worth asking Cantor & Nissel in the UK - Google, this forum won't accept the link.]

 

She had infantile cataracts and has very short axes as well; not a great combination!

I did suggest that she try a combination of +20 CLs and glasses for the rest, which interested her. I have the trial CLs and she is coming later today. However, I suspect that given her large vertex (about 16-17mm) she'll need quite a bit of additional plus; probably +12 or greater. Still, she'll have more usable vision than with her current +25D glasses script, which limits her fields tremendously. The good news is that she needs < 1D cyl.

All this said, it should be possible to get a custom pair of CLs in her full script. I should have a better idea of the numbers after her refraction today.

 

Any hope of implanting?
She sounds microphthalmic and maybe has little room to spare or maybe the capsules are shot ?
Anterior chambers got any space?

Maybe some bright IOL maker could come up with a very high index version ?

 

No chance of implants--no structures and very little AC space. The only chance this girl has for decent vision is CLs. Right now she really struggles to see with spectacles, and is limited in her daily activities quite severely. It is really too bad, as her acuity is better than 20/40 o.u. with correction.

I did order her some +20 CLs and will try glasses over this. I'll wager she'll come in around +13D or so, given her vertex. Still, it will be some improvement