Dr. Daddi Fadel and Dr. Melissa Barnett, both optometrist and contact lens experts, begin by explaining the basics of the scleral lens, mainly the definition and advantages. We learn about the different conditions for which scleral lenses can be used therapeutically using case studies as examples.
- Sjogren’s Syndrome
- Limbal Stem Cell Deficiency
- Vascularized Limbal Keratitis
- Neovascularization secondary to Fuch’s Dystrophy
- Ptosis
- Lipid Keratopathy
- Neurotrophic keratitis
- Persistent Epithelial Defects
- Salzmann Nodular Degeneration
- Neovascularization with scleral lens
Next, we move on the complications with the scleral lenses and the common problems with patients. We learn about the management of these issues and other ocular surface diseases.
It is essential to educate patients well about basic hygiene and ocular hygiene habits that we must recommend them to develop. We talk in-depth about the review of solutions used for different contact lens activities like rinse, disinfection, and storage.
Dr. Barnett explains lens wettability and how different lens surface treatments can improve patient comfort. Dr. Fadel talks about midday fogging and how to improve the patient experience. Lastly, we learn about the various solution brands that are available and the benefits of each solution. The session ends with an interesting question and answers segment for the live audience.
References
Papers
Fadel D, Kramer E. Potential contraindications to scleral lens wear. Cont Lens Anterior Eye. 2019 Feb;42(1):92-103.
https://pubmed.ncbi.nlm.nih.gov/30392894/
Cressey A, Jacobs DS, Carrasquillo KG. Management of vascularized limbal keratitis with prosthetic replacement of the ocular surface system. Eye Contact Lens. 2012 Mar;38(2):137-40.
https://pubmed.ncbi.nlm.nih.gov/22327201/
Cherny C, Sherman SW, Dagi Glass LR. Severe Chronic Progressive External Ophthalmoplegia-Associated Ptosis Successfully Treated With Scleral Lenses. J Neuroophthalmol. 2021 Jun 1;41(2):e189-e191.
https://pubmed.ncbi.nlm.nih.gov/32349064/
Sacchetti M, Lambiase A. Diagnosis and management of neurotrophic keratitis. Clin Ophthalmol. 2014 Mar 19;8:571-9.
https://pubmed.ncbi.nlm.nih.gov/24672223/
Woods J, Hutchings N, Srinivasan S, Jones L. Geographic distribution of corneal staining in symptomatic dry eye. Ocul Surf. 2020 Apr;18(2):258-266.
https://pubmed.ncbi.nlm.nih.gov/31352082/
Cressey A, Jacobs DS, Remington C, Carrasquillo KG. Improvement of chronic corneal opacity in ocular surface disease with prosthetic replacement of the ocular surface ecosystem (PROSE) treatment. Am J Ophthalmol Case Rep. 2018 Feb 15;10:108-113.
https://pubmed.ncbi.nlm.nih.gov/29552666/
Mickles CV, Harthan JS, Barnett M. Assessment of a Novel Lens Surface Treatment for Scleral Lens Wearers With Dry Eye. Eye Contact Lens. 2021 May 1;47(5):308-313.
https://pubmed.ncbi.nlm.nih.gov/33156128/
Sindt C, Bennett E, Szczotka-Flynn L, Sclafani L, Barnett M; American Academy of Optometry (AAO) Section on Cornea, Contact Lenses & Refractive Technologies, and The American Optometric Association (AOA) Contact Lens and Cornea Section. Technical Report: Guidelines for Handling of Multipatient Contact Lenses in the Clinical Setting. Optom Vis Sci. 2020 Aug;97(8):544-548.
https://pubmed.ncbi.nlm.nih.gov/32769840/
Books
Scleral lens issues and complications – Daddi Fadel
https://sclerallensbook.com/collections/book
Contemporary scleral lenses: theory and application – by Melissa Barnett and Lynette Johns
https://www.amazon.com/Contemporary-Scleral-Lenses-Ophthalmology-Developments-ebook/dp/B077JR1TCP
A guide to scleral lens fitting – Eef van der Worp
Clinical guide for scleral lens success – Melissa Barnett and Daddi Fadel