Achromatopsia and Albinism

Rod monochromacy or achromatopsia is an autosomal recessive congenital color defect. Those who have achromatopsia have abnormal or absent cone function that causes debilitating photophobia. Dark-tinted glasses can help with symptoms; however, spectacles may not always be cosmetically acceptable. A dark-tinted colored contact lens can reduce light exposure in a more cosmetically acceptable way.

Those who have albinism have a lack of ocular pigment and iris transillumination defects. Therefore, these patients are also very light sensitive. These children can benefit from heavily tinted or opaque-iris-ring contact lenses that help block light.

Above picture shows a patient who has light sensitivity from a transillumination iris defect from ocular albinism. This patient would benefit from a colored contact lens light sensitivity.

Colobomas

Iris colobomas can be corrected cosmetically using an iris-occluding prosthetic contact lens. Patients who have this condition are often photosensitive and can benefit from a black backing on the posterior surface of the lens to help block light. Those who have iris coloboma may also have lenticular and retinal involvement that will limit vision.

Microcornea

Those who have unilateral microcornea have a pronounced difference in their visible iris diameters. This can be corrected cosmetically with a prosthetic contact lens that has a limbal ring to increase the appearance of the overall size of the cornea.

A Case for Fitting a Tinted Soft Contact Lens

A 12-year-old boy presented with complaints of severe migraines from bright outdoor lighting. Dark sunglasses helped relieve his symptoms; however, he wanted to be able to use his full peripheral vision while participating in sports and other extracurricular activities. A dark brown tinted soft contact lens completely resolved his symptoms.

A 12-year-old boy fitted into a brown tinted lens (right eye) to help with light sensitivity.