Orthoptic anomalies are prevalent: they are encountered in at least 5% of patients seen in a typical primary eyecare practice. Several cases are reviewed that highlight the role of
contact lenses in treating
orthoptic anomalies. In particular,
contact lenses are the preferred optical approach to the correction of
anisometropia, and it is often argued that
anisometropia should be corrected as young as possible. However, fitting
contact lenses to patients, particularly children, with
anisometropic amblyopia has been problematic because there is no immediate
binocular acuity improvement when the
contact lenses are inserted which reduces patient motivation. Continuous wear with
silicone hydrogels represents a breakthrough for these cases and some illustrative case studies are given. The visual deficit in
amblyopia can be reduced in some cases solely by fitting
contact lenses, without the need for occlusion
therapy. Other
orthoptic uses of
contact lenses are reviewed including: correcting motor deviations, occlusion, and infantile onset nystagmus. It is concluded that there are
orthoptic anomalies where
contact lenses are the preferred mode of correction. It is in patients' best interest for practitioners to discuss
contact lenses in these cases.