This session consists of 3 patient records. Case 1 has a high astigmatic correction and a large cornea. Discussion will centre around the options available for the px and the challenges of lens stability. Case 2 is a px who has keratoconus and how the Eye Care Professional would identify and manage the px while waiting on the referral appointment to the hospital eye service to be fulfilled. Case 3 is a high astigmatic presbyope with a small cornea who would like the option of contact lenses. The discussion will focus on the options, adaptation and the successful prediction of success at the time of dispensing.