Interpalpebral Fitting Philosophy: A Rarely Used Approach to Keratoconus Management With Corneal Rigid Gas-Permeable (RGP) Contact Lenses.

This unique case report demonstrates an unusual approach to managing keratoconus: the interpalpebral fitting philosophy. This technique is rarely used in contact lens practice. In contrast, the lid-attachment fitting philosophy is more commonly utilized. The interpalpebral fitting is a challenging task concerning lens centration and stability. This report underscores the potential efficacy of the interpalpebral fitting approach in keratoconus patients with specific characteristics, such as large palpebral apertures. A 25-year-old man presented to our center for an eye examination, complaining of blurred vision. Upon examination, both eyes showed signs of keratoconus. The visual acuity without glasses was 20/400 for the right eye and 20/200 for the left eye. Visual acuity with the best correction was as follows: right eye 20/80 with -6.00/-2.50 x 45 and left eye 20/60 with -3.00/-4.00 x 145. Examinations revealed that the patient was suitable for contact lens wear, with no contraindications identified. Corneal rigid gas-permeable contact lenses with an 8.70 mm diameter were fitted according to the interpalpebral fitting strategy. The patient reported good adaptation to the lenses, with acceptable initial comfort. The fitting was excellent, resulting in a marked improvement in visual acuity, achieving 20/20 in each eye. The key takeaway from this study is that the interpalpebral fitting method is a viable option for managing keratoconus in patients with large palpebral apertures.