Ophthalmology · Refractive Surgery and Contact Lenses (LASIK, SMILE, PRK, Keratoconus Management)

A rigid gas-permeable contact lens with base curve 7.40 mm is fitted on a cornea with keratometry 7.50 mm @ 180 and 7.90 mm @ 90. The lens fit is likely to be:

  • A Too steep (flat cornea, steep lens)
  • B Too flat (steep cornea, flat lens)
  • C Aligned fit (lens and cornea match)
  • D Cannot be determined from this data
Correct answer: B. Too flat (steep cornea, flat lens)

Explanation

The base curve of 7.40 mm is steeper (more curved) than the flattest K of 7.50 mm. However, the steepest K is 7.90 mm, meaning the lens base curve is actually flatter than the average corneal curvature and much flatter than the steep meridian. For a flat-fitting relationship, the lens base curve should be flatter than the corneal K. Here the lens is steeper than the flat K but much flatter than the steep K, creating an unstable, flat-fitting relationship. The key concept: lens base curve 7.40 mm < corneal curvature on average means lens is relatively flat compared to corneal shape.

Reference: Contact Lenses, 6th Edition (Phillips, Speedwell), 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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