Case report assisted and written by Wendi Zhang from the Illinois College of Optometry. Presumed graduation date of May 2025.
A 17-year-old female patient was referred by a local ophthalmologist for a corneal evaluation and scleral lens fitting. The patient developed severe central corneal scarring with neovascularization encroaching on the visual axis due to an etiology of “unknown keratitis” three years ago.
She had been treated with topical antiviral, antibiotic and steroid medications in the past. She also received a single round of mitomycin corneal intravascular injections OU, resulting in “insignificant vision improvement” per the patient. However, she was unable to follow up with the doctor due to the COVID-19 pandemic.
The patient’s BCVA with spectacles is 20/50 OU due to significant irregular astigmatism shown on the pentacam imaging. Dr. Holland (and Wendy) fit her with a custom scleral lens, achieving a BCVA of 20/30 in each eye.
He also prescribed Prednisolone BID OU for a week, with a tapering schedule to once daily OU for an additional week. Additionally, he considered the need for repeating the mitomycin intravascular injection to prevent further corneal scarring and potentially improve vision.
A future update will need to be give on the outcome of this procedure if the patient chooses to undergo another round of mitomycin corneal intravascular injections.
For now, the patient is satisfied with her improved vision and can now, visually, pass a drivers test.
