Scleral lenses have become a mainstream option for the treatment of
distorted corneas and ocular surface disease. Well-fit scleral lenses vault the cornea and
are supported entirely by the sclera. They create a tear layer reservoir which helps
neutralize an irregular, damaged or diseased cornea while creating constant lubrication
and necessary oxygen supply. They provide optics comparable to corneal gas
permeable lenses, with equivalent comfort to soft contact lenses. Like any type of
medical treatment, there must be first and foremost an understanding of the disease
process and pathology being treated when fitting scleral lenses. Without true
understanding of the disease process and its limitations, practitioners may inadvertently
induce complications. A comprehensive understanding of the intended scleral lens
design and fitting parameters is paramount. Equally important is establishing a close
relationship with the lens manufacturing laboratory and their consultants. This is
particularly critical when troubleshooting challenging cases. Establishing appropriate
scleral lens follow up and close communication with the referring corneal or medical
specialist is very important. Proper understanding of the disease process and its
limitations are important to avoid scleral lens induced complications. Appropriate
follow up and adequate collaboration with specialists is also essential to ensure
successful treatment with scleral lenses. From the care and handling aspect as well as
disease management strategies, patient communication and involvement can improve
compliance and favorable outcomes.
Keywords: Abrasion, Application, Comfort, Corneal abrasion, Corneal
Neovascularization, Edema, Fogging, Graft Rejection, Hyperemia, Impression
ring, Injection, Keratitis, Neovascularization, Non-wetting, Pain, Problem
Solving, Prolapse, Redness, Removal, Visual Acuity.
