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Seen Nee Chia, Bernadine Hegarty, Clifford R Weir; Intractable diplopia - do patients like occlusive contact lenses?. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2567.
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Intractable binocular diplopia is a distressing symptom not amenable to conventional management of diplopia. Despite an established modality of treatment, there is limited data on the use of occlusive contact lens in intractable diplopia. We aim to evaluate our experience of the use of occlusive soft contact lens in the management of this condition.
A retrospective study of all patients who were issued with an occlusive contact lens for binocular intractable diplopia at our institution between 2009 and 2013.
Nineteen (n=19) patients were identified, mean age at initiation of contact lens wear of 41 years (range 14 - 67 years), 7 males (36.8%). The main cause of intractable diplopia was neurogenic (9 patients, 47.4%), from tumours (3), vascular (3), trauma (2) and demyelination (1). Four patients failed to attend within the first year. Of the remaining 15 patients, the mean total follow-up time was 4 years (range 1 month to 17 years). Thirteen out of the fifteen patients had more than one year follow up. Thus far all patients have tolerated contact lens wear and only one patient had to transiently discontinue wear due to corneal ulcer post stereotactic radiosurgery for recurrent meningioma. Of the patients who continue to attend, all were satisfied with the comfort, occlusiveness adequate to eliminate diplopia, improved function and cosmesis. Assuming continued attendance indicates satisfaction with occlusive contact lens as a treatment of intractable diplopia, the “success rate” of those issued with contact lens is 73.7%.
This small study indicates that occlusive contact lens is an effective and safe treatment in the majority of patients issued with such lenses.
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