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Janet Castrillo O.D.

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United States
Miami, FL
Janet Castrillo O.D.

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

10/17/2025

🔦 Optic Section — small beam, big information 👁️
A narrow slit beam can reveal subtle findings across the cornea, anterior chamber, and lens.
🔍 Clinical uses:
Evaluate corneal layers for scars, edema, or infiltrates
Estimate anterior chamber depth
Detect early lens changes (NS, cortical, PSC)
Localize foreign bodies or opacities
A simple technique that continues to be one of the most diagnostic tools in our slit lamp routine.

10/15/2025

🩺 Macular OCT — subtle findings, major impact 👁️
The macula provides our sharpest central vision, and OCT imaging has become indispensable for detecting subtle structural changes that aren’t always visible clinically.
📈 Clinical relevance:
Routine macular OCTs can reveal early or asymptomatic changes, allowing timely referral, treatment, or closer monitoring.
🔍 Common findings on macular OCT:
Drusen and RPE irregularities — early AMD
Subretinal or intraretinal fluid — exudative AMD, CSR, or DME
Epiretinal membrane (ERM) — causing macular puckering and distortion
Macular hole or lamellar hole — central vision loss risk
Vitreomacular traction (VMT) — subtle tractional changes before hole formation
Diabetic macular edema — cystoid spaces or diffuse thickening
Central serous retinopathy (CSR) — serous detachment of the neurosensory retina
🔬 Even in patients with 20/20 acuity, macular OCT can reveal early pathology — emphasizing the value of imaging beyond fundus exam findings.

09/23/2025

👁 Scleral lens fit evaluation — note the presence of bubbles beneath the lens.
While scleral lenses can provide excellent vision and comfort when fit properly, trapped bubbles disrupt the smooth optical surface and can lead to:
🔹 Blurred or fluctuating vision
🔹 Decreased lens comfort
🔹 Potential corneal desiccation if bubbles persist
A proper application technique and careful fit assessment are essential to ensure a uniform tear reservoir without air gaps.

09/19/2025

💧 Tear film assessment in a patient with reduced TBUT. An unstable tear film leads to fluctuating and blurred vision, often worsening with reading or screen use.
⏱️ Measured TBUT: 10 seconds)
👓 Best corrected with spectacles: 20/25, but patient reports fluctuating clarity
💧 With ocular surface treatment (lubrication & lid hygiene): improved comfort and more stable vision
Evaluating tear film stability is essential in managing ocular surface disease — not all blurry vision comes from the cornea or lens.

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.

09/11/2025

🎥 From Blurry to 20/20 — Thanks to Scleral Lenses 👁️✨
This patient has keratoconus, a condition where the cornea (the front surface of the eye) becomes thin and cone-shaped, distorting vision. Glasses and soft contacts just weren’t enough — but with custom scleral lenses, they’re now seeing 20/20! 🙌
🛡️ These lenses vault over the irregular cornea and rest on the white part of the eye (the sclera), creating a smooth optical surface and holding a reservoir of fluid that keeps the eye hydrated and comfortable.
💡 For many patients with keratoconus, scleral lenses can restore not just vision — but quality of life.
👓 From legally blind to crystal clear — this is the power of specialty lenses.
#20/20Vision

09/09/2025

🎥 When Blood Flow Gets Blocked in the Eye
This patient experienced sudden vision loss due to a branch retinal vein occlusion (BRVO) — a blockage in one of the small veins that drains blood from the retina. When this happens, blood and fluid can build up, damaging the delicate retinal tissue and affecting central or peripheral vision, depending on the location.
🩸 and when things back up, vision can change in an instant.
treatments like anti-VEGF injections can help reduce swelling, some vision loss may remain.
👁️ Early detection is critical — especially in patients with high blood pressure, diabetes, or vascular issues.
💬 Have you seen BRVO in your practice? What’s your go-to for long-term management?

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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08/25/2025

👁️ Glaucoma: The Silent Thief of Sight 👁️
Glaucoma often develops without warning—no pain, no symptoms—until vision loss has already begun. It’s one of the leading causes of irreversible blindness, but early detection through routine eye exams can make all the difference. 🧠💡
🎯 Regular comprehensive eye exams are the key to catching glaucoma early and preserving your sight. Whether you’re in your 40s or over 60, routine checks with your optometrist or ophthalmologist are essential.
🩺 This is a team effort! Shout out to all the GPs, pharmacists, diabetes educators, and other healthcare professionals who help identify risk factors and refer patients for eye care. Together, we’re protecting vision—one patient at a time. 💪👓
📅 Haven’t had an eye exam in a while? Now’s the time.

05/05/2025

Macular OCT: small scan, big impact.
From subtle fluid to early atrophy, OCT gives us a window into the neurosensory retina that clinical exam alone can’t match. Whether it’s unexplained vision loss, diabetic screening, AMD monitoring, or macular hole suspicion — OCT is your best diagnostic ally.

Key reasons to perform a macular OCT:

Unexplained central vision changes
Monitoring diabetic macular edema
Detecting early AMD or CNV
Assessing for vitreomacular interface disorders (ERM, VMT, macular hole)
Pre- and post-injection or surgical evaluation.

05/01/2025

Neovascularization of the iris (NVI) — an early sign of serious posterior segment ischemia. Think CRVO, PDR, OIS. Early detection is key to preventing neovascular glaucoma. Always investigate the systemic and retinal cause.

04/17/2025

Treatment for Metallic Foreign Body in the Cornea

1. Immediate Action:
- Don’t rub the eye or try to remove it yourself.
- Lightly cover the eye and seek medical help right away.

2. In-Office Treatment:
- An eye doctor uses a slit lamp to locate and assess the object.
- After applying numbing drops, the metal is removed with a swab, needle, or burr (for rust).
- A rust ring, if present, is cleared with a special tool.
3. Aftercare:
- Antibiotic drops/ointment to prevent infection.
- Possibly cycloplegic drops for pain.
- Follow-up to check healing.

4. Watch for Complications:
- Infection, vision changes, scarring, or corneal ulcers. Seek emergency care if symptoms worsen or vision declines.

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