Piggyback Cosmetic Contact Lens as an Occlusion Therapy in a Patient With Familial Dysautonomia
Bibliographic record
Abstract
PURPOSE: The purpose of this case report is to explore the treatment of ocular and visual complications secondary to familial dysautonomia (Riley–Day syndrome) on an 8 month-old baby. Treatments for corneal scarring,ocular protection, and amblyopia were achieved by fitting a scleral lens with a unique piggyback combination involving a cosmetic soft contact lens. METHOD: The patient was seen in February 2008, on referral from a corneal specialist, for a scleral lens fitting. This case was comanaged from Université de Montréal with the help of the Boston Foundation for Sight.Examination revealed a right cornea with opacities. We planned to use scleral lenses to treat this eye and to protect the other one. Although the patient's ocular condition did improve, some concerns arose about potential impact on her visual development. Our treatment for amblyopia involved the use of atropine in both eyes and penalization of the good eye with a cosmetic opaque contact lens that we fitted onto a piggyback system over the scleral lens. The rationale behind this approach is explained in this article. RESULT: After the contact lens was fitted and after penalization and atropinization,the baby's visual condition improved. Time will tell to what degree this treatment is effective. CONCLUSION: Familial dysautonomia is a challenging condition for the eye because of the presence of alacrymia and lack of corneal sensitivity. Scleral contact lenses and cosmetic contact lenses offer a unique way of addressing many issues, such as corneal healing and amblyopia, raised in this case report. These devices may be considered for any other case that requires corneal tissue healing and visual development.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".