What are Scleral Lenses?
Meet my patient, a 58-year-old female who came to my office with terrible redness, burning, tearing eyes and sensitivity to light. She has used many treatments previously without success. I made the diagnosis of severe dry eye. The patient was fit with scleral lenses and was able to see better than 20/20 in each eye. In addition, she is able to wear the lenses all day long comfortably. Scleral lenses are large diameter gas permeable lenses that rest beyond the limits of the cornea on the sclera. They were first used in late 1800s and early 1900s however now the manufacturing process is more reproducible.
When do you need scleral lenses?
– primary and secondary corneal ectasias
– post-corneal transplants
– corneal scars
– corneal dystrophies or degenerations
– severe dry eyes
– graft versus host disease
– Sjogren’s syndrome
– Stevens-Johnson syndrome
– neurotrophic keratopathy
– chronic inflammatory conditions such as limbal stem cell deficiency or ocular cicatricial pemphigoid.
Clearance (the space between the cornea and scleral lens) is a key advantage to scleral lenses. The cornea is bathed all day long with saline, which rejuvenates the ocular surface. This is unlike other types of contact lenses (including soft and small diameter gas permeable lenses) that may compromise the ocular surface.
Scleral lenses are a life-changing opportunity for many. In my practice, scleral lenses have helped people who previously have not been able to see or function with other types of contact lenses or glasses.
There have been numerous advancements in scleral lenses in the past year. Multifocal scleral lenses are now available allowing both distance and near vision are now available.
~Melissa Barnett, OD, FAAO