Systematic evaluation of scleral lens fitting is essential to identify and
address areas of concern at the outset with a view to minimizing the risk of potential
physiological complications. Thorough and consistent evaluation ensures proper
functionality, comfort and safety for the patient. This chapter details scleral lens
evaluation techniques ranging from immediately after application to subsequent fitting
evaluations. Scleral lens evaluation can be intimidating relative to other contact lens
modalities since the lenses are much larger and have more variables that can be
changed. Systematic and methodical evaluation ensures that practitioners do not
overlook key findings of ill-fitting scleral lenses. After scleral lenses are removed, the
ocular surface tells its story as well. At every evaluation, practitioners should always
remember to evaluate the eye without the lens to ensure that the patient is not
compromised and can continue to enjoy all the properties that a scleral lens offers.
Keywords: Blanching, Bubbles, Clearance, Compression, Conjunctiva,
Conjunctival hypertrophy, Evaluation, Fluorescein, Hyperemia, Impinging,
Inside-out evaluation, Light, Limbus, OCT, Scleral compression, Settling, Slit
lamp, Staining, Surface wettability, Toricity, Vessels.
