COMFORTINT We recommend inserting ComforTint level 2 tint on one eye and the level 3 tint on the fellow eye. Let the lenses settle a few minutes and then ask the patient which shade density they prefer. Have the patient try the lenses in different lighting situations including outdoors and at a computer screen. If the patient desires an even darker shade, piggy back the lenses on one eye and see if that brings more relief to their photophobia. A level 3+ density can be ordered as well as a lighter level 1 density. However, most true photophobia patients will prefer a level 2 or 3.
If there is excessive lens movement, a small number of patients may experience distraction from the tint border dropping like a curtain after each blink. If this persists after 30 minutes of settle time, ComforTint can be ordered in a steeper base curve. In addition to Metrosoft, other tint-friendly materials and monthly modalities are available upon request. As a note, Silicone Hydrogel lenses tint very poorly and are not an option for ComforTint at this time.
PROSTHETICS It helps to know the horizontal visible iris diameter (HVID) in order to choose an iris pattern. If a black pupil is needed, measure the fellow eye pupil in bright and dim conditions. A good rule of thumb is to add 0.5mm to the average of the two since the lens will be more cosmetically noticeable under indoor conditions. You want a tighter than average fit with adequate movement for tear exchange under the lens.