R Venkataramanan

R Venkataramanan

R Venkat's Blog

R Venkat's Blog
"To be an Inspiring Teacher,one should be a Disciplined Student throughout Life" - Venkataramanan Ramasethu



Sunday, March 15, 2009

Friends I am very sad to note that Prof. Theodore Grosvenor passed away on the 3rd of March, 2009 at his home in Tucson, Arizona.


I am very sad to note that Prof. Theodore Grosvenor passed away on the 3rd of March, 2009 at his home in Tucson, Arizona. Prof. Grosvenor was born on April 19, 1923. He graduated from The Ohio State University with both his O.D. and PhD. He taught at the University of Houston College of Optometry, The Illinois College of Optometry, and The College of Optometry in Waterloo. He was an adjunct faculty at the Pacific University, College of Optometry. He was also very instrumental in starting the Optometry program at the university in Auckland, New Zealand. He was a very prolific writer with several hundred articles and numerous books published. Most of us in the Optometry profession are indebted to him for his book "Primary Care Optometry", which till date is considered one of the most comprehensive works on the clinical techniques of Optometry. Prof. Grosvenor death is surely a great loss to his family and to the Optometric profession as a whole

Sunday, March 1, 2009

Rose K Post Graft - Wow!


Patient is female, 25 years old and was referred to our clinic (Dec 2008) with the following noteworthy history and findings:
Myope since childhood

Had her LASIK surgery done BE - 2003

Post LASIK infection RE leading to a need for keratoplasty

Penetrating keratoplasty done RE-2004

Patient developed cataract in RE and was operated along with IOL implantation RE-2003

On Examination:

Unaided eye vision RE = 6/60 LE =6/12

Best corrected visual acuity with glasses: RE -3.00Dcyl x 20 6/18 LE -1.25DSph 6/6p
RE shows obvious 360 degree surgical scar of keratoplasty with healthy graft.
Keratometry: (Ref index of 1.332 CZ)
(irregular mires + in all meridians)
RE 52.0 @ 130 LE 45.0 @ 40
↔ RE 6.38mm @ 130 LE 7.38mm @ 40
While LE was fitted with regular RGP lens and VA of 6/9 (clear) was achieved, RE did not tolerate regular RGP. The lens on RE was unstable, poorly tolerated and with marginal visual reward.
For OD:
Patient was explained about Rose K Post Graft lens and she consented to try.
The trial lens tried was:
BC 6.60 (calculated empirically as 0.3mm steeper than average K). This was too flat.
Thus the final selected trial lens was:
BC = 6.40
DIA = 10.4
Power = -15.5
Edge Standard
Over refraction: +6.00D
VA = 6/6p
Fluorescein pattern was practically parallel with good centration, stable vision and good subjective comfort.
We prescribed:
BC = 6.40
DIA = 10.4
Power = -9.00
Edge Standard
Boston XO
Ultraviolet protected
Rose K Post Graft,
VA on the dispensing visit OD = 6/6p, Fluoroscein fit good and ame as in trial fitting. Vision was stable and patient was very happy on achieving good vision in RE again.
A) The Rose K Post Graft lens performed better than regular RGP due to:
Larger diameter
Better optics
Reverse geometry
Better edge design
Perfect repeatability of design as in trail lens
b) The power was calculated by adding the vertexed over-refraction to trial lens power.
c) Boston XO material was chosen because of the high Dk value (in order to provide near-natural oxygen flux through the lens to this already 'eventful' cornea).
D) Fluoroscein pattern through this Ultrviolet protected lens could be seen through the Wratten filter (Kodak filter #12)
E) Violet colour was chosen because our clinic fits Rose K2 lenses in blue. Just looking at violet colour in future (even before seeing patient data sheet) will give us an indication that this is Rose K PG lens.

In all, this was a very gratifying experience and a 'win-win' situation for manufacturer, dispenser and the patient.

Rajesh Wadhwa
Optometrist, New Delhi, India
B.Ophth.Tech Hons.(AIIMS)
B.Sc.Hons. (DU),
Fellow of International Assoc. of Contact Lens Educators (Australia),
PG Dip. in Management