This patient was diagnosed with keratoconus in the early 1960’s. 40 years ago he received a corneal transplant in his right eye and 20 years ago received a corneal transplant in his left eye. For 32 years he wore gas permeable lenses. While he was able to see relatively well with these lenses, they were painful to wear and would pop out of his eyes numerous times each day. Notice the profile photos of his corneas below. His transplanted corneas are so profound and the center of gravity is so far out that any gas permeable contact lens will not be stable on his eyes. 8 years ago we provided this patient with GVR Scleral lenses. These lenses are able to vault over the transplanted corneas and come to rest on the white portion of his eyes (the sclera). Because these lenses fit nicely under his eyelids and don’t move, they are unable to be dislodged with normal eye movements. The interface between the back surface of the lenses and the front surface of the corneas is filled with sterile saline solution. In other words, his corneas are always in a liquid environment. This patient has been able to wear his lenses all day comfortably for over 8 years with excellent vision. Over these years, his corneas have remained clear and stable and have maintained their integrity.