Today’s patient is a 35 year old Hispanic male who is coming in for his annual exam. He is reporting some increased mild blur in his glasses, which he did not bring into the exam. He also wants to try contact lenses. He is otherwise healthy, has no allergies, and is not taking any medications.
Incoming visual acuity is OD 20/60, OS 20/50. Pupils, EOMs, and confrontation fields are all normal in both eyes.
Refraction results are:
OD: plano -4.00 x 017 20/20-
OS: -0.25 -2.75 x 159 20/20
Refraction results from two years ago showed 0.50D less cyl in the right eye but otherwise everything else was stable.
Anterior segment is clear and normal in both eyes, IOPs are 16/16, and posterior segment is normal with small nerves and small cups of 0.20 round OU, clear posterior poles, and stable lattice degeneration in each eye compared to 2 years prior.
How would you counsel this patient in terms of their wanting contact lenses? What would be your first choice to try? Is there additional testing you want to perform before trying lenses? Is there any hesitation recommendation contact lenses given he’ll be 40 in just a few more years?