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CASO CLÍNICO: Lente de Contacto Escleral en paciente con Miopía Magna y Membrana Pupilar Persistente

La Membrana Pupilar Persistente (MPP) es una alteración
congénita que consiste en la interrupción, en
algún momento de la gestación, de la regresión normal de la membrana pupilar.
Así, persisten restos embrionarios que puedan originar defectos permanentes en
la córnea, iris o cristalino.

En este caso, además de dicha condición ocular, la paciente
presenta una elevada miopía y astigmatismo que hace que su visión sea
deficiente. Siempre ha usado lentes de contacto blandas con las que alcanzaba
una visión del 60% con cada ojo, pero ahora no tolera dichas lentes por
problemas de ojo seco evaporativo.

Por todo ello, decidimos adaptar lentes de
contacto RPG esclerales con las que alcanza una mejor visión (90% con cada ojo)
y además, se beneficia de la comodidad que ofrecen estas lentes con sus ojos
hidratados todas las horas de uso (unas 10h al día).

Lente de Contacto RPG de apoyo Escleral adaptada en paciente con miopía alta y MPP (Verdejo A, COVER)
Imagen de la condición ocular vista de frente mediante iluminación difusa, tras previa instilación de fluoresceína.
Imagen de la condición ocular vista mediante iluminación directa (paralelepípedo) la lente escleral y mediante retroiluminación la MPP
Imagen de la condición ocular vista lateral mediante iluminación directa (sección óptica) el menisco lagrimal entre lente-córnea y mediante retroiluminación la MPP

Problemas de Visión y Déficit de Atención con Hiperactividad (TDAH)

Según un nuevo estudio de la Universidad de Alabama (UAB) en Birmingham, realizado con más de 75.000 niños de edades comprendidas  entre los 4 y 17 años, la prevalencia del TDAH es mayor en aquellos niños que tienen problemas de visión no corregidos. En concreto, el 15,6% de los jóvenes con problemas visuales presentaban un diagnóstico de TDAH más severo frente al 8,3% de niños con visión normal.

Por lo tanto, según dicho estudio, antes de diagnosticar un posible problema de aprendizaje por déficit de atención, impulsividad o hiperactividad en un niño, sería conveniente llevar a cabo una valoración visual completa por parte de un optometrista y así, poder detectar cualquier problema visual que interfiera en su aprendizaje. De esta manera, se podría tratar dicho problema mediante Terapia Visual y evitar otros problemas relacionados con su conducta y que podrían afectar a su rendimiento académico.




“Al igual que nuestros músculos se benefician del ejercicio físico, ciertos problemas de visión pueden mejorarse gracias a ejercicios supervisados por un optometrista”. Dicho tratamiento se conoce como Terapia Visual y es efectiva principalmente en niños pero también puede puede ser un tratamiento indicado en adultos. Por ejemplo, en aquellos adultos que tienen fatiga visual y cansancio ocular cuando trabajan con ordenador.

Si quieres saber más sobre la Terapia visual y los beneficios que este tratamiento puede aportar a niños y adultos, pincha en el siguiente enlace para leer el artículo publicado en la revista “Salud Visual”




“Si un niño se pasa todo el día jugando con la tablet o el móvil será miope con toda probabilidad”

Debido a los actuales hábitos de vida, se está produciendo un gran aumento de la miopía en la población juvenil. Por ello y según importantes estudios, se plantea el pasar más tiempo al aire libre y el tratamiento con lentes de orto-k, como los métodos más eficaces para intentar controlar el aumento de dicha miopía.



Orto-k en Hipermetropía

La ortoqueratología u orto-k es un tratamiento que consiste en la adaptación de lentes de contacto con un diseño especial para eliminar la refracción de los pacientes de manera temporal, mientras se están usando las lentes, sin necesidad de usar corrección óptica (gafas o lentillas blandas) durante el día y aun así, viendo perfectamente. El paciente debe colocarse las lentes antes de ir a dormir y retirarlas de sus ojos al levantarse, es decir, que solo las usa por la noche mientras duerme.

Las lentes de orto-k pueden eliminar defectos refractivos de miopía, astigmatismo y ahora también, con los nuevos diseños de lentes,  refracciones de hipermetropía. A pesar de ser un tema muy interesante, son muy pocos los estudios publicados al respecto. Por ello, en este post os dejamos un estudio en el que hemos participado y donde intentamos demostrar la eficacia de las lentes de orto-k en el tratamiento de la hipermetropía.

Pincha en este enlace para acceder al estudio:

López de Dueñas M, Gallego Antón L, Liern Cendrero A, Verdejo del Rey A. Eficacia y seguridad de un diseño de lentes de contacto para ortoqueratología en hipermetropía. Optom 2018


Técnicas de control de miopía en niños

Como ya hemos comentado en otros post, el aumento de la miopía infantil es cada vez mayor. De manera que según los estudios, sabemos que en países asiáticos el 80-90% de la población es miope y en España se estima que en el año 2050, la mitad de la población será miope. Además de la elevada incidencia, otro problema paralelo es que si esa miopía infantil sigue aumentando en dioptrías y llega a valores elevados (cosa muy probable) el riesgo futuro que tendrían estos niños de padecer enfermedades oculares más importantes (degeneraciones retinianas, glaucoma,..) es elevado.

Por todo ello, creemos que es importante dar a conocer los tratamientos que existen actualmente para intentar frenar o ralentizar el aumento de la miopía en los niños. Además, hay que destacar que dichos tratamientos están avalados por numerosos estudios científicos, en alguno de los cuales, está participando como investigador-colaborador el director de nuestro centro, Antonio Verdejo.

Para entender estos métodos sobre el control de la miopía, os dejamos un vídeo que han realizado un compañero optometrista y la asociación de miopía magna AMIRES.

Vídeo ¡Cómo frenar tu miopía!                           niños_gafas