Janet Castrillo O.D.

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Janet Castrillo O.D. Optometrist with focus in specialty contact lenses. Managing
Keratoconus, Dry eye and Myopia Control

Corneal topography is where Ortho-K starts. 👁️For our fellow optometric professionals, topography provides the data we n...
08/22/2026

Corneal topography is where Ortho-K starts. 👁️

For our fellow optometric professionals, topography provides the data we need to assess corneal shape, identify treatment patterns, and make informed Ortho-K lens design decisions.

📍 During treatment: Allows us to evaluate treatment centration, corneal response, and the progression of the treatment zone.

📍 Follow-up:Helps identify subtle changes and determine whether adjustments to lens design or fit may be needed.

Every map tells a story—and understanding the topography is key to optimizing the fit and visual outcome.
Good Ortho-K starts with good data. 🔬
MyopiaControl OptometricPractice ContactLensSpecialist Cornea OptometricEducation EyeCareProfessionals

📍Case Spotlight: Keratoconus17-year-old patient presented with longstanding blurry vision and best-corrected vision of 2...
06/04/2026

📍Case Spotlight: Keratoconus

17-year-old patient presented with longstanding blurry vision and best-corrected vision of 20/150.

Key findings:
• Irregular astigmatism
• Sc******ng reflex on retinoscopy
• Inferior corneal steepening on topography

Diagnosis: Keratoconus.

A good reminder that when vision doesn’t match the refraction, it’s time to look deeper. Early diagnosis can make a significant difference in preserving vision.

VisionCare

Not every corneal infiltrate is the same 👁️This slit lamp image demonstrates a focal corneal lesion with surrounding str...
05/26/2026

Not every corneal infiltrate is the same 👁️

This slit lamp image demonstrates a focal corneal lesion with surrounding stromal haze. Findings like these may represent:

• Herpetic keratitis
• Bacterial corneal ulcer
• Fungal keratitis
• Contact lens–associated keratitis
• Post-infectious corneal scarring

Early diagnosis is important, as some corneal conditions can progress rapidly and threaten vision if left untreated.

Clinical history, staining patterns, symptom presentation, and follow-up evaluation all help guide diagnosis and management.

Educational purposes only.

📊 Corneal topography of a patient with keratoconus. The irregular steepening is consistent with ectasia, limiting vision...
09/17/2025

📊 Corneal topography of a patient with keratoconus. The irregular steepening is consistent with ectasia, limiting vision with traditional glasses.
👓 Best corrected with spectacles: 20/50
🟢 Best corrected with scleral lenses: 20/20
Specialty contact lenses not only improve visual acuity but also provide a smooth optical surface, helping patients regain functional vision. Early diagnosis and proper management make all the difference.

🧠 Scleral Lens Fit: Let’s Talk Edges 👀When was the last time you evaluated edge alignment as critically as the central a...
08/26/2025

🧠 Scleral Lens Fit: Let’s Talk Edges 👀

When was the last time you evaluated edge alignment as critically as the central and mid-peripheral fit?

👉 A well-designed edge profile can make or break scleral lens comfort and wearability.

🔍 Key things to watch for:

Lift-Off:That subtle edge gap may look harmless, but can lead to conjunctival prolapse or midday fogging.
Compression:Too much bearing? Watch for blanching, impingement, or that dreaded “bulge” of conjunctiva beyond the haptic.
Toric vs Quadrant Specific:One size doesn’t fit all. Asymmetry in scleral shape is the norm, not the exception—toric or quadrant-specific haptics often improve edge alignment dramatically.

💡 Pro tip:Use scleral profilometry or fluorescein + slit lamp with indirect illumination to assess the landing zone in detail.

Comfort and long-term eye health start at the periphery.

👁️‍🗨️ Let’s elevate our fits—one edge at a time.

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