Contact lens fitting is an exciting, progressive discipline. Advances in surgical technique produce unique challenges for the contact lens fitter as the cornea is reshaped in everchanging ways. Contact lenses may delay or prevent the need for surgery, be used in conjunction with surgical techniques as part of the visual rehabilitation plan or they may be required after unforeseen complications and surgical failures. Advances in lens design and materials are allowing practitioners to manage an increasingly wide range of cases effectively, pushing the boundaries of correction of refractive errors and fitting topographical irregularities. 

In this article we present four challenging cases from our Contact Lens Clinic at Manchester Royal Eye Hospital (MREH) in which contact lenses have successfully been fitted using the latest materials, design and technology.