RGP Contact Lenses

and
Astigmatism

Prof. M. O. Oriowo
PhD, FNOA, FAAO
Department of Optometry & Vision Science
University of Ilorin
 Incidence of Astigmatism
33% of refractive errors have
at least 0.75DC

* Bennett & Rabbets, 1984

Oxygen
Transmissibility
of Disposable
Soft Torics
1) Labelled lens power -3.00/-1.25
(or -1.00) x 180
2) Based on manufacturers’
claimed values of centre
thickness; lens topography
derived from low force gauge
thickness measurements
(compression factor corrected)
3) Dk calculated using Fatt
boundary & edge corrected
formula based on manufacturers’
water content

Hickson-Curran et al,
Optician Feb 2000
 Physiological Responses

• Hypoxia and Oedema

– Dk/t of torics lower than
sphericals counterparts
– Avoid excessive prism
ballast
– Use mid or high water with thin
lens profile for higher Dk/t
• SiH toric lens designs
Oxygen
Transmissibility
of Disposable
Soft Torics
1) Labelled lens power -3.00/-1.25
(or -1.00) x 180
2) Based on manufacturers’
claimed values of centre
thickness; lens topography
derived from low force gauge
thickness measurements
(compression factor corrected)
3) Dk calculated using Fatt
boundary & edge corrected
formula based on manufacturers’
water content

Hickson-Curran et al,
Optician Feb 2000
 Why Rigid Lenses ?
• Astigmatism – Visual stability.
• Oxygen.
• Economy.
• Ortho – K treatments.
 Forces that affects the
Contact Lens on the Eye.

• Capillary effect.
• Eyelids.
• Gravity.
• Friction.
• Edge Clearence.
 Best fit:
• Parallel to Cornea.
• Large Back Optic Zone Diameter with
spherical corneas.
• Decreased Back Optik Zone Diameters with
increased Astigmatism.
• When difference between the two Corneal
meridians exeed 0,3 mm – make back torics.
 Spherical Lens Designs.
• Large BOZD – tri curve
8.05:8.4 / 9.55: 9.0 / 11,00 : 9.6

• Medium BOZD – four curve

8.00: 8.0 / 8.50:8.5 / 9.50: 9.0 / 11.0 : 9.5

• Small BOZD – five curve or aspherical

7.95:7.1 / 8.10:7.7/ 8.35:8.3 / 8.85:8.9 / 10.0:9.5
 When you apply
the lens:
• Clean with surfactant cleaner.
• Rinse thoroughtly with tap water.
• Re-wet with wetting solution.
• Spray with saline solution.
• Let the patient look down until tearing have
stoped completely.
 Refraction and Contact Lenses

Cornea: 7.8 x 7.8 in 90 Rx: -3.00 sph.

7.80 –3.00 = -3.00 = ORX: 0.00

7.85 –3.00 = -3.25 = ORX: +0.25

 Refraction and Contact Lenses

Cornea: 7.8 x 7.7 in 90 Rx: -3.00 = -0.50 x 180

7.80 –3.00 = -3.00 -0.50 x 180 = ORX: 0.00

7.75 –3.00 = -2.75 = -0.50 x 180 = ORX: -0.25

 Refraction and Contact Lenses

Cornea: 7.8 x 7.7 in 90 Rx: -3.00

7.80 –3.00 = -3.00 -0.50 x 0 = ORX: 0.00 +0.50 x 0

7.70 –3.00 = -2.50 -0.50 x 0 = ORX: -0.50 +0.50 x 0

 Toric Lens Designs

• Back toric – only cylinder on the back.

• Bi toric – cylinder back and front.

• Edge toric – only toric back periferal.

• Front toric – only cylinder on the front.

 Back Toric Design

Is used when a spherical rigid Contact Lens gives Residual

Astigmatism.
The Residual Astigmatism has to be with axis along the flat
corneal meridian.

The difference between the flat and steep meridian is

calculated from the Residual Astigmatism.

The difference between the radiae of the Contact Lens

must never exceed the difference between radiae on cornea.
 Bi-toric Design

Is used where Residual Astigmatism will result in a difference

between the Contact Lens radiae that will exceed the difference
between Corneal radiae, or where a spherical Ridgid Contact
Lens gives a induced astigmatism (axis along steep meridian).

It can also be used where a spherical Ridgid Contact Lens

gives full correction, but where a toric back surface is needed.
An alternative to this could also be a Edge-toric design – but
only in cases of moderat corneal astigmatism (0.3 –0.4 mm)
 Edge-toric Design

Can be used where a spherical Ridgid Lens gives full

correction, but where a toric back surface is needed.
(Corneal astigmatism between 0.3 – 0.4 mm)

An alternative to this is a bi-toric design.

 Front Toric Design

Is used to correct residual or induced astigmatism on

Contact Lenses with a spherical back surface.
These Lenses is stabilized with Prism Ballast and Truncation.