Scleral Lens


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We are now providing a much needed contact lens service to our patients. With 30 years of rigid contact lens experience and the acquisition of the Cirrus 5000 anterior segment technology and topography, Dr. Gendal is now fitting scleral lenses.

Scleral lenses offer certain advantages over corneal lenses. First of all, large-diameter lenses may be more comfortable for patients than corneal lenses. The cornea is one of the most highly sensitive tissues in the body. The conjunctiva (soft, clear tissue that lies over the sclera) is much less sensitive than the cornea. So, lenses that rest primarily or exclusively on the conjunctiva may induce less sensation than smaller lenses that rest upon the cornea.

In some patients, corneal tissue is damaged. Scleral lenses trap a reservoir of fluid behind the lens. This fluid protects the cornea, and may even allow it to heal in some cases. Corneal lenses can become decentered, and may even become dislodged. Since scleral lenses extend under the upper and lower lids, they rarely dislocate.

Which patients will benefit from scleral lenses?

Patients with irregular corneas, patients with conditions that affect the tear film, and patients with refractive error (nearsightedness, farsightedness, or astigmatism) who are unable to wear other forms of correction could benefit from scleral lenses.

Conditions such as keratoconus and pellucid marginal corneal degeneration cause irregularity in the surface of the eye. Surgery (keratoplasty, refractive surgery) can also lead to corneal irregularity. If the cornea is not smooth, vision will not be easily correctable with spectacles or most soft contact lenses. Scleral lenses mask this irregularity and allow for clearer vision by providing a smooth front surface through which light can enter the eye.

Some patients have disorders that affect the quality or quantity of tears that help to keep the eye’s surface smooth and healthy. Dry eye syndrome, graft vs. host disease, Sjogren’s syndrome, Stevens Johnson syndrome, and neurotrophic keratopathy are examples of such conditions. Some inflammatory conditions, including limbal stem cell deficiency and ocular cicatricial pemphigoid, also cause serious damage to the front surface of the eye. Patients who cannot close their lids completely may also experience problems with the health of the surface of the eye. The fluid reservoir trapped beneath a scleral lens may improve comfort for these patients, and may allow the corneal surface to heal.

Patients who need visual correction, but are unable to wear other contact lenses, may find larger-diameter lenses more comfortable than other lens designs. Scleral lenses may be particularly useful for these patients.