I came to see Dr. Maller with significant nearsightedness, huge astigmatism and pellucid marginal degeneration, which is not as a bad as it sounds. As I understand it, pellucid is a condition that indicates an "out-of-round" cornea; mine has a pouch or sag in it, like a pear shape, which causes the astigmatism, but is otherwise not really dangerous or progressive. The solution for 20/20 vision is topographically mapped gas perm lenses, which can correct the vision loss caused by the irregular shape of my cornea. The only fly in the buttermilk is that these lenses are expensive, which was an issue for me as my main sport is surfing, and I lose at least a few lenses a year. The Doc assured me that I'd probably lose more gas perms, as they are easier to lose than the soft lenses I had used previously.

The first solution the Doc suggested was a hybrid lens, a gas perm center and a soft "skirt" that made the lens hard to lose. So hard to lose, in fact, that I had some difficulty learning to remove them. In addition to that little problem, the fact that there are fewer parameters for the Doc to work with on the hybrids meant that my vision wasn't as good as it could have been with gas perms. Finally, the skirt ripped on me one day, and, envisioning a future of such rips (the hybrids are expensive as well), and the removal difficulties, and the less than perfect vision results, we looked to the next step.

That step was a "piggyback" system. I wear my inexpensive disposable soft lenses, which give me about 20/40 vision, for surfing and other on water activities where the risk of loss is high. For other times, the Doc topographically mapped a set of gas perms on top of the soft lenses, which bring me to 20/20 or better. I put this second set over the soft lenses (hence the "piggyback") for everything but surfing. When we get to the beach, I pop the gas perms out and surf on the cheap soft lenses. Back in the car I put the gas perms in for the drive home.

This system has worked wonderfully; I get the crisp vision I've always wanted, and don't risk losing several expensive lenses a year to mother ocean. The few growing pains and issues are the following. An important part of the piggyback is making sure enough oxygen gets to the eye, as there are now 2 layers of lenses to get through. So the Doc made the lenses as small and thin as possible. This means they are easier to lose and to inadvertantly break. I've lost lenses in carparks in Europe, on numerous beaches, and inside many rental cars, but I've usually found them again. Once, however, the lens was so scratched by its time on the floor of the rental car grinding around with the coarse black sand of Costa Rica, that it was a write-off. Another time, in cleaning the lens in the sink I hit the drain plug with the lens and saw it explode into a million little pieces (not as dramatic as the book). Still, I'm spending less on lenses than risking expensive gas perms in the ocean, and getting better vision than the hybrid, and much better vision than regular soft lenses.

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