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Case J, S - OrthoKeratology with VERY FLAT Ks, VERY LOW eccentricity
This case probably WOULD be impossible with one of the non-custom ortho-k lens brands out there. I wasn't certain that it could be done even with WAVE, but I knew that the only shot I had would be to design in AXIAL mode
One of the takeaways I got from this case was that when a patient tells us that their VA starts out great in the first half of the day but wears off quickly, even after weeks of wear when the VA should be stable all day....or they complain that some days the VA is really good but other days it's really bad, the likely reason is not enough TD for that patient's combination of their amount of refractive error, degree of corneal flatness, and low eccentricity. My staff was totally convinced that this kid wasn't wearing his lenses every night (as he said he was), and I must say that I certainly had the same thought a number of times.
Jim Edwards, your WAVE program never ceases to surprise and challenge and delight me!
Jeff Jeruss OD
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