Contact lens treatment for severe sicca with suspected alacrimia in a six-year-old child

Purpose. The aim of this case report is to describe a case of suspected alacrimia in a six-year-old child that resulted in irregular astigmatism with risk of amblyopia. A specialty contact lens fitting for visual rehabilitation was performed.

Material and Methods. Different wearing modes (extended wear and daily wear) as well as contact lens types (soft silicone hydrogel contact lenses of different wearing rhythms, as well as rigid gas permeable (RGP) contact lenses were fitted.

Results. In this case, different contact lens types (soft and
rigid contact lenses) could not achieve a satisfactory treatment result. However, a piggyback contact lens system with daily wear was a good treatment solution.

Conclusion. Irregular astigmatism in children is always a high risk of amblyopia. For this reason, timely optical treatment for visual rehabilitation is a high priority. Sometimes it is necessary to combine different contact lenses and wearing modalities to achieve the best solution for a complex treatment situation.