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Spectacular Sclerals

An Underrated Specialty Contact Lens

Article by James Schweiger O.D.

Photography by James Schweiger O.D.

Intro

Scleral lenses are extraordinary, multi-dimensional tools that not only offer relief for severely dry and irritated eyes but also provide sharp vision correction for even the highest prescriptions and uniquely shaped eyes. 

How Scleral Lenses Work

Scleral lenses are large, specialized contact lenses that vault over the entire cornea and rest gently on the white part of the eye, known as the sclera. After insertion with a preservative-free saline solution, these lenses continuously cushion, hydrate, and protect the eye's surface. Their highly breathable design allows oxygen to flow to the eye, promoting health and comfort. Due to their rigid structure and independence from the cornea, scleral lenses are often a superior choice compared to soft contact lenses or glasses, especially for vision correction.

Who Can Benefit from Scleral Lenses

Scleral lenses are beneficial for individuals with:

  • Myopia (Near-sightedness)

  • Hyperopia (Far-sightedness)

  • Irregular Astigmatism

  • Extreme Dry Eye

  • Keratoconus

  • Corneal Dystrophies

  • Ocular Cicatricial Pemphigoid

  • Recurrent Corneal Erosions

  • Non-Healing Epithelial Defects

  • Corneal Scarring

  • Exposure Keratopathy

  • Graft vs Host Disease

  • Corneal Transplants

  • Aphakia

  • Post-LASIK or Post-RK

Fitting Process

The fitting process for scleral lenses involves several steps:

  1. Measurements: a corneal topographer is used to map the size, elevation and curvature of the front surface of the eye. 

  2. Fitting: In-office assessments of the lens are made using inspection under a slit-lamp microscope and scans from an anterior optical coherence tomography (OCT).

  3. Vision Correction: Prescription is added in a similar fashion to finding a glasses prescription, but while the lenses are on the eyes.

  4. Adaptation Time: Patients may require time to adjust to new lenses. Multiple fit adjustments may be necessary to ensure optimal vision, comfort, and effectiveness.

Insertion, Cleaning, and Longevity

Scleral lenses are inserted by filling them with a saline solution and placing them directly onto the eye. Proper insertion and cleaning techniques are essential for ensuring comfort, effectiveness, and longevity of the lenses. With proper care, scleral lenses can last for several years, but regular check-ups with an eye care professional are necessary to monitor their condition and fit.

Why We Use Zenlens by Bausch and Lomb

This collection of scleral lenses comes with specialized curves to align with the eyes’ natural toric shape, enabling a more efficient fitting process. Customizing the starter lens shape to better match the patient's eye using Zenlens’ multiple features allows for a better fit, vision and improved comfort. Optimizing the fit mitigates most of the complications and negative symptoms associated with extended wear. 

SmartCurve Technology: This proprietary technology simplifies scleral fittings by allowing eye care professionals to customize the shape of the lens with ease, saving patients time on return fitting appointments.

Advanced Peripheral System (APS): Zenlens offers an adjustable landing zone where all four quadrants of the lens edge adjust independently. This system ensures accurate landing on the sclera and reduces instances of compression and impingement.

MicroVault Technology: This feature allows for peripheral elevations, like pinguecula or scarring, by creating a precise vault over the obstruction, ensuring comfort and reducing irritation.

HOA Correction: Higher-order aberrations (HOA) are distortions of light passing through irregular refractive surfaces. This feature neutralizes HOAs to enhance visual clarity and reduce issues like glare and halos.

Extended Depth of Focus: For patients with presbyopia, have options for multifocal or monovision correction for near focusing issues.

Annual Fit Checks for Fabulousness

Eyes on Hayden’s promise for premium patient care includes yearly specialty lens consultations to monitor eye wellness and lens fit. Regular visits help ensure the lenses continue to perform safely and effectively and can help screen for and address any issues that may arise. 

Takeaways

Scleral lenses remain a fantastically underutilized therapy for vision correction and severe dry eyes. Besides its use in treating ocular disease, they can be a great option for even normal shaped eyes with mild vision problems. Sclerals literally hold moisture against the eye throughout the day, making them an excellent choice for people living in dry, arid climates where dust and low humidity prevail, like Arizona. They can be great for people, such as college students and office workers, who spend long hours staring at screens and rarely blink. If you are tired of wearing glasses, and have been disappointed by how irritated your eyes feel by the end of the day after wearing your soft contact lenses, then it might be time for an upgrade. Enjoy the best combination of comfort and vision with custom-fitted scleral contact lenses.

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