About our Specialty Lens Practice: The Global Vision Rehabilitation Center

Our specialty lens practice is devoted to the restoration of quality vision and ocular comfort to patients who have been impacted by corneal diseases, ocular trauma, chronic dry eye, ocular surgery complications, and many corneal degenerations and dystrophies. Many patients who have lost vision due to many corneal conditions such as keratoconus or refractive surgery complications such as LASIK or Radial Keratotomy (RK) have visited our specialty lens practice over the years from almost every state and over 50 countries from around the world. Thousands of our patients are wearing our uniquely designed scleral lenses that have allowed them to function normally once again. Information about this amazing technology can be found at: https://www.sclerallens.com.

The Global Vision Rehabilitation Center in the oldest and one of the largest specialty scleral lens practices in North America. For 30 years we have been associated with many eye institutions and universities that have sent their students to our facility for advanced contact lens and scleral lens training. These former students who are now doctors are helping patients around the world to see clearly and comfortably once again.

For decades our practice has been at the leading edge of treating patients with progressive myopia (nearsightedness) through the use of specialty gas permeable lenses that we design. Recently, FDA approved soft contact lens options were introduced that have been clinically proven to slow or even stop the progression of myopia in children. The GVRC is a pioneer in the use of orthokeratology also known as “orthok” for the non-surgical treatment of myopia. When a nearsighted patient is properly fit with an orthok designed gas permeable contact lens, the patient’s level of myopia can be significantly reduced or eliminated when the orthok lenses are removed. We are passionate about treating myopia in children because if left untreated a number of pathological conditions can develop later in life. These conditions include myopic macular degeneration, glaucoma (at lower intraocular pressures) retinal and vitreous degenerations and reduced best corrected visual acuity. It is estimated that 40% of all retinal detachments are due to high myopia. For more information about this life changing technology please visit: https://www.orthok.com.

The challenging issues described above is what the GVRH is devoted to. It is our main and only focus. Our mission is to restore quality vision to those patients who have often struggled with poor vision for many years. To accomplish this, we have equipped our practice with the latest cutting edge technologies specifically designed to address the many challenging vision and comfort issues that so many of our patients have to deal with on a daily basis. Most of the equipment that we use every day will not be found in a “conventional” eye practice. This is why we are different and unique among all of the optometric and ophthalmic practices. Our patient care philosophy is best reflected in the words of Robert Kennedy: “There are those who look at things and ask why…. I dream of things that never were and ask why not?”

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Visante Optical Coherence Tomography

Visante OCT

Anterior segment optical coherence tomography (OCT) has become an important tool for evaluating the cornea and the anterior segment or front portion of the eye. Cross sectional tissue images of these ocular structures can be generated in vivo, for detailed analysis.

The clinical applications of anterior segment OCT are extremely important and useful. Cross-sectional images of the cornea, anterior chamber, crystalline lens and iris can be obtained in a manner that no other technology can provide. These images can be invaluable in the diagnosis and management of many anterior segment diseases and conditions such as keratoconus, corneal transplants, corneal ectasia, narrow angle glaucoma, and many other corneal dystrophies and degenerations.

In addition to the above uses of this technology, our specialty lens practice uses optical coherence tomography to assist us in gaining a better understanding of many of the complex corneal conditions that we see and treat. We are using OCT technology to help us create more sophisticated scleral lens designs for specific corneal conditions and diseases. Our goal is to use this technology and new emerging technologies that we possess to allow our “hi need” patients regain useful functional vision along with excellent comfort.

Note in the attached images how the OCT allows the fit of the lens to be assessed at all points along the cornea and sclera.

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Why is it so Hard for Doctors to Get it Right when it comes to Fitting High-Need Patients with a Specialty or Scleral Lens?

Over the years I have received many inquiries from prospective patients about specific specialty contact and scleral lens designs. Most of the inquiries come from patients who have suffered significant vision loss due to keratoconus, corneal transplant surgery, refractive eye surgeries such as LASIK and RK, chronic dry eye, ocular trauma and a host of ocular conditions and diseases.

What must be understood and appreciated is that there are many different lens technologies available to treat these conditions. In addition, these technologies are constantly evolving as is the technology to diagnose and treat these conditions. Because there is so much technology and specialty lens designs available, patients will need to find a doctor with a great deal of experience not only in treating all of these conditions, but also knowledgeable with all of the many specialty-contact and scleral lenses currently available.

Our specialty lens practice, known as the Global Vision Rehabilitation Center, uses the most advanced technologies to help us diagnose and treat all of the conditions listed above. In addition, I approach the selection, design and use of these lenses as an art form. What will work well on one patient’s eye may not work well on another patient. Each lens technology is a tool or instrument that I use to improve vision and ocular comfort. Within each specific lens design or technology, there are fine details that the patient may not be aware of. For example, lenses can be made from different polymers, with each polymer having a specific characteristic. All of the specialty contact lens and scleral lens designs are made with many different curvatures with varying diameters. Any one or all of these lens parameters can be changed as needed during the initial fitting procedure or at any one of the subsequent follow up visits.

Every patient is unique and has vision demands unique to that individual. In addition, every eye is different. Many patients have lost vision and comfort due to LASIK and RK surgeries. Other patients have undergone corneal transplant surgery and have irregular and dry corneas. Other patients have been negatively impacted due to corneal disease and trauma. Every patient is carefully examined by me. After this is done, a decision will be made as to what lens technology will be best suited to restore quality vision and comfort once again. It is important to understand that the fitting procedure is a process. After the patient receives their lenses, careful examinations are done at all of their follow-up visits. At any of these follow-up visits, small adjustments to the lens design may need to be done. It is very important for both the doctor and patient to have patience with the process. As I tell all of my patients, we are embarking on a journey.

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Why I am Passionate about Scleral Lenses

I am often asked why I am so passionate about scleral lens technology. My answer will be a question: How many non-invasive technologies have the ability to provide clear, comfortable vision to a patient who previously suffered from ocular pain along with distorted, non-functional vision? How many non-invasive technologies are there that can dramatically change lives? Our lives revolve around our vision. There are millions of people around the world suffering ocular pain and vision loss due to corneal disease, trauma, ocular surgery and a host of other ocular conditions that can be successfully treated with scleral lens technology.

Scleral lens technology is the fastest growing and the most innovative technology within the contact lens industry. Our specialty scleral lens practice is the oldest and one of the largest scleral lens practices in North America. We have patients with significant vision issues visiting us from over 50 countries around the world. The following photos and images are examples of what a well-designed and fit scleral lens can achieve:

The eyes displayed here belong to patients who had no functional vision until we fit these eyes with scleral lenses. All of these patients are now seeing clearly and comfortably, often years of non-functional vision until they received their scleral lenses.

The following eye cannot close due to an acoustic neuroma. We designed a lens to keep the eye moist at night.

Some eyes are so distorted that it is not possible to provide the patient with a scleral lens using conventional technology. In cases like these we have to take an impression of the ocular surface and then send the impression to a special laboratory where 3D printing technology is used to make this highly customized lens where every “hill and valley” along the ocular surface is replicated onto the back surface of the EyePrint Pro scleral lens.

This is a photo of a scleral lens over an eye with an extremely rare condition known as “Stevens Johnson Syndrome”. This eye was scheduled to undergo surgery several months after this photo was taken. We fit this eye with a scleral lens in order to keep the ocular surface moist and to protect the eye from the environment and the blinking action of the eyelids.

The eyes below developed corneal irregularities after radial keratotomy. These irregularities were either present immediately after the surgery, but could develop many years later.

This eye was damaged due to trauma and surgery.

Scleral lens over a very profound eye with a corneal transplant.

These images show a scleral lens over a corneal transplant. Note the stitches.

This image shows a scleral lens over an eye with keratoconus. The lens vaults over the cone.

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Corneal Haze from Epithelial Ingrowth After Lasik

This is a photo of an eye that underwent LASIK surgery 15 years ago and developed epithelial ingrowth several years later. The arrow on the left is pointing to the epithelial ingrowth and resultant corneal haze. Over the years, the LASIK flap (note arrow on extreme right) was lifted several times and the underlying tissue rinsed with sterile saline. However, the epithelial ingrowth returned after each treatment. This patient was fit with a scleral lens which is providing this patient with clear, comfortable vision once again. As far as the future for this eye is concerned, we just don’t know.
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Eye Print Pro Following Chemical Explosion

I am presenting these images to demonstrate how a well designed and fit scleral lens can change a patient’s life. This is why I am so passionate about this technology and the work that I do.
These are photos of the left eye of a patient who lost vision due to a chemical explosion over 20 years ago. This explosion caused this patient to lose his right eye. Vision in the left eye is a work in progress. Recently, the left eye underwent a corneal transplant operation along with a glaucoma shunt procedure.
After cataract surgery last year, the eye continued to have no functional vision due to the extremely distorted ocular surface resulting from the chemical explosion and multiple subsequent surgical procedures. Restoring vision with a conventionally designed scleral lens was impossible. As such, our only option was the EyePrint Pro scleral lens (EPP), since this lens is specifically intended for the many eccentricities of the front surface of this eye.
An impression was taken of the ocular surface, then sent to a special lab where 3-D printing technology is used to make a high tech scleral lens. Every “hill and valley” of the ocular surface will be replicated onto the back surface of the EPP scleral lens. Based on the initial examinations, we expect this patient to be able to achieve at least 20/50 vision with the EPP scleral lens.
Patients like this very nice person make me want to come to the office every morning and never retire. I love my profession and love changing lives.



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