A new trend in fitting irregular corneas has emerged over the past few years: SCLERAL CONTACT LENSES.
While scleral contact lense have been around for about 125 years, they have reemerged as a viable option for those who require vision correction. A scleral lens is a large lens that is unique in design in that it fits onto and is supported by the sclera, the white portion of the eye, and creates a tear-filled vault over the cornea.
Modern scleral lenses are made of a highly oxygen permeable polymer and are designed to treat a variety of eye conditions, many of which do not respond to other forms of treatment. They offer numerous advantages over traditional gas permeable lenses including better centration, improved comfort, and a negligible possibility of a lens popping out of the eye.
Scleral lenses are utilized for gas permeable intolerant patients, keratoconus, post penetrating keratoplasty, post RK, dry eye and Stevens- Johnson syndrome. The vaulted corneal fit of these lenses decrease microtrauma to the corneal surface, reducing the mechanical rubbing of the lens on the apical cornea, which is important in keratoconus and corneal grafts. Patients with pre-existing apical or traumatic scarring, those with injuries to the eye such as surgical complications, distorted corneal implants, as well as chemical and burn injuries also may be treated by the use of scleral lenses.
The tear reservoir created by the vaulted shape of a scleral lens can be a successful treatment option for patients with intractable dry eyes and corneal dystrophies where the corneal surface is compromised. Likewise, they work well on patients with irregular corneas secondary to the increased stability of the lens.
Lens designs are fit from semi-scleral (13.5 mm diameter) to scleral (up to 22 mm) designs. High Dk lens materials are used to allow greater oxygen permeablilty. Patients need to be specifically trained in the application and removal of these lenses and frequently a DMV plunger is necessary due to the large diameter of the lens.
At Corneal Associates of New Jersey, we offer all types of scleral lenses to fit the various needs of our patients. Should you have a patient who you think would benefit from scleral contact lenses, please schedule a consultation with Dr. Sorkin.