By Marisol Rodriguez, LDO, ABO-AC, NCLEC

Halloween came and went, and of course eye care professionals are on high alert, warning our friends and family to go through the appropriate channels to acquire costume contact lenses. We all know too well how quickly a medical emergency can arise from a contaminated or ill-fitting contact lens. While I admire the artistic detailing that goes into designing these colored lenses, to be honest, this year my thought process took a hard pivot. I started to think about corneal dystrophies and how cosmetic or prosthetic contact lenses are an emotional solution for patients.

When I was diving deeper into education in preparation for my basic certification for the National Contact Lens Examiners (NCLE-C) and then consecutively for my Contact Lens Fitters license, there was a plethora of corneal and ocular dystrophies, and anomalies we had to be familiar with, such as, kerataconus, Fuchs’ dystrophy, acanthamoeba keratitis, coloboma, heterochromia, etc. Many of these medical conditions not only present visual and/or physical discomfort, they also present quality of life or emotional discomfort for these patients. While we do not treat ocular health conditions, it is absolutely necessary that we are familiar with these conditions because we are ophthalmic dispensers, and our knowledge doesn’t have to be limited to only frames and lenses. Even if you are not walking down the path to fitting contact lenses, expand your network. Become familiar with practitioners, clinics, and organizations to whom you can refer patients to for continued care. The goal is always to assist the person in need with a solution to improve their visual demands and quality of life.

Mr. David Watson, a dear friend and amazing resource for knowledge in this area is a Licensed Optician, and Contact Lens Fitter. He was also an opticianry school professor in Canada for more than 20 years. He was kind enough to share a case history that was life changing for one of his clinic's patients.

I’m going to share the conversation and images he provided for the case.

Fig. 2  Healthy eye

Fig. 1  Opaque cornea

Fig. 3  Prosthetic contact lens

“Patient had severe trauma years ago and has lived with a completely opaque cornea. She hates the way she looks. Almost had surgery to remove the eye because she hates it so much.

Has tried to wear opaque contacts but they all have a clear center, so the opaque cornea still shows. Has tried to get custom lenses made a few times but everywhere she goes nobody knows who to order from or where to start.

She was referred to our office by her ophthalmologist and we got talking. Years ago I used to fit contacts for the movie industry and had an idea about who to contact. Told her I would look into it. Fast forward 2 mos. She came in today to try the lens on for the first time.

I had a completely custom hand painted prosthetic contact for her. She cried for 10 minutes when she saw herself. Not gonna lie. I joined her for a minute. She's so happy. When you can change or enhance a life like that it's indescribable.”

Fig. 4  Contact on eye

Fig. 5 Can you guess the eye with the contact?


Fig. 6  View of the lens through a slit lamp

If you’re interested in exploring more contact lens related education search our Pro to Pro Continuing education articles. Another great resource would be the Contact Lens Society of America.