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My Paragon CRT® Success Story Brie Headshot
Michelle Gan, O.D.
Excel Eyecare Optometry, San Diego, CA  |   Fitting CRT Since 2005

"My practice continues to grow, thanks to the many referrals I receive from satisfied
CRT patients!"

Gloria and Angela are very cute 10-year-old twins  CRT Guy
who love to be outdoors. Both girls were wearing CRT® lenses for approximately two years when they became new patients in my practice.  Gloria and Angela complained of blurry vision and had a difficult time seeing the board at school.  When asked "what do you like most about your CRT lenses," the response echoed what I hear every day: "Not having to wear lenses during the day!"

Gloria's best corrected visual acuity was: OD: 20/60 and OS: 20/40, with significant astigmatism. She was wearing CRT lens parameters of:
  • OD:  8.9 BC   .525 RZD   -32 LZA   10.5 DIA
  • OS:  9.0 BC   .525 RZD   -32 LZA   10.5 DIA
Angela's best corrected vision was: OD: 20/80 and OS: 20/40, with significant astigmatism.  She was wearing CRT lens parameters of:
  • OD:  9.0 BC   .525 RZD   -31 LZA   10.5 DIA
  • OS:  9.2 BC   .525 RZD   -32 LZA   10.5 DIA
Corneal topography revealed that both girls had been wearing CRT lenses that were too shallow in sagittal depth, which resulted in lenses that were decentering in a superior position and inducing a lot of astigmatism.

Their mom asked me if I could improve the girls vision and keep them in CRT.  Based on their corneal topography and irregular shaped corneas, I instructed the twins to stop wearing their CRT lenses.  I prescribed daytime soft contact lenses in varying powers and explained to their mom that the girls vision would most likely change each day as their corneas regressed back to their original shape.  The girls were frustrated and didn't want to return to wearing lenses during the day, but in the end, they did give up their CRT lenses.  At that time, their prescriptions were:

Gloria:     OD:  -3.50 -1.00 x 155          OS:  -4.00 -0.75 x 015
Angela:   OD:  -3.50 -0.75 x 025          OS:  -3.50 -1.00 x 020
A year later, my CRT Clinical Coordinator received
a call from Gloria and Angela's mom.  She explained the girls were experiencing rapid nearsighted progression.  Because the twins disliked wearing daytime contacts, she scheduled an appointment for the girls to be refit in CRT.  Before their visit, I carefully studied the collected data from their previous practitioner and reviewed each case with the CRT consultant at Paragon. 

Gloria and Angela's mom was correct about their myopic progression, and because Gloria had a higher prescription and her corneas were more irregular than her sister's, I decided to start the fitting process with her.

Gloria's prescription was:
  • OD:  Flat "K": 43.12     -5.00  -1.25 x 160
                                                  (-1.50D increase in myopia progression in one year)

  • OS:  Flat "K": 43.00     -6.00  -1.00 x 015
                                                  (-2.00D increase in myopia progression in one year)
I fit her with CRT lenses in the following parameters:
  • OD:  8.9 BC   .550 RZD   -33 LZA   10.5 DIA
  • OS:  9.0 BC   .550 RZD   -33 LZA   10.5 DIA
After the lenses settled for a few minutes, I performed a fluorescein pattern evaluation.   Both lenses centered well over the pupil and had a nice, even treatment zone of approximately 4mm.  In the Return Zone area, there was a solid, 360-degree band of fluorescein for the central corneal epithelial cells to migrate to, and the edge lift allowed for sufficient tear flow underneath the lens.  The spherical over-refraction in both eyes was +0.50D, which confirmed I had the correct Base Curve to correct her nearsightedness.

Bulls Eye Topography      

Gloria began treatment that evening and on her first morning follow-up visit, her CRT lenses had treated over half of her prescription.  At Gloria's one-week follow-up visit, her vision was: OD 20/20 and OS 20/30.  At her one-month follow-up visit, both eyes were 20/20.

Angela started wearing CRT again and her vision improved to: OD: 20/25 and OD:  20/30 at her one week follow up. One month later, her vision was 20/20 in both eyes.  The whole family was very happy and excited that Gloria and Angela could, once again, enjoy the many benefits of CRT.  They are most excited about having clear vision all day long, plus the freedom of not wearing glasses or contact lenses while at school.

"My practice continues to grow, thanks to the many referrals I receive from satisfied CRT patients!"
Michelle Gan, O.D.
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