Comment on the Case Report of “A Miniscleral Contact Lens Fitting in a Patient of Unilateral Terrien’s Marginal Degeneration”

Dear Editor, I am writing to address some concerns regarding the dynamic fitting assessment described in the recent case report titled “A miniscleral contact lens fitting in a patient of unilateral Terrien’s marginal degeneration” author by Jain et al.[1] While the authors provide valuable insights into the management of corneal ectasia using miniscleral contact lenses, there are certain drawbacks in the dynamic and static fitting assessment methodology that warrant attention. The authors reported that the dynamic fitting assessment was conducted using fluorescein staining in cobalt blue filter of the slit lamp, revealing adequate edge lift with no perilimbal blanching of the vessels. However, it is crucial to note that while the static fitting assessment utilized fluorescence dye, the dynamic fitting assessment in contact lens was performed without fluorescein staining.[2] This discrepancy raises the concerns about the consistency and reliability of the dynamic fitting evaluation. Ensuring proper fit and comfort of contact lenses is crucial, especially for irregular corneas such as those in Terrien’s marginal degeneration cases. Fluorescein staining is a common technique used to evaluate contact lens alignment, edge lift, and overall fitting characteristics. This process, referred to as static fitting assessment, provides valuable insights into the interaction between the lens and the ocular surface, enhancing comfort and effectiveness. Thank you for considering these methodological concerns. I believe addressing these issues will contribute to the advancement of evidence-based practice in contact lens fitting and improve the quality of care for patients with corneal ectasia. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.