Clinical Scorecard: Contact Lenses: Applying AS-OCT

At a Glance

Key Highlights

• AS-OCT measures tear meniscus height and area, aiding in dry eye disease assessment.
• It provides precise corneal imaging for early detection of keratoconus.
• AS-OCT is beneficial for fitting all types of rigid contact lenses, especially scleral lenses.
• Measurements of corneal vault and limbal clearance are critical for successful lens fitting.
• Comparative readings between AS-OCT and Scheimpflug-based imaging are reliable but should not be used interchangeably.

Guideline-Based Recommendations

Diagnosis

• Use AS-OCT to evaluate tear meniscus for dry eye disease diagnosis.
• Employ AS-OCT for early detection and assessment of keratoconus.

Management

• Utilize AS-OCT for fitting and evaluating specialty contact lenses.
• Adjust lens fitting based on AS-OCT measurements of corneal clearance and edge alignment.

Monitoring & Follow-up

• Capture AS-OCT images at initial fitting and follow-up after lens wear to assess fit and clearance.

Risks

• Avoid using AS-OCT and Scheimpflug imaging interchangeably due to differences in keratometry readings.

Patient & Prescribing Data

Patients with dry eye disease and those requiring specialty contact lenses.

AS-OCT enhances the fitting process by providing detailed measurements necessary for optimal lens performance.

Clinical Best Practices

• Ensure a minimum of 150 μm corneal clearance and 60 to 80 μm limbal clearance when fitting lenses.
• Assess lens fit by capturing images in different gaze directions to identify impingement or lifting.

References

• Optical Coherence Tomography in Contact Lens Practice
• Keratoconus Detection with AS-OCT
• Comparative Studies on AS-OCT and Scheimpflug Imaging