This is a photo of me with our student externs Amanda Golchin on the left and Jena Adelsberger on the right. On my left is our keratoconus patient Alvaro, who has been visiting our practice from Montevideo, Uruguay. Alvaro has a very advanced case of keratoconus which cannot be corrected with eyeglasses or conventional contact lenses. I first examined Alvaro in 2009 when we fit him with GVR Scleral lenses. Over these years Alvaro has traveled to Miami 3 times for eye examinations and scleral lens evaluations. Without his scleral lenses, Alvaro has no functional vision. With his GVR Scleral lenses Alvaro is corrected to 20/25 vision in each eye. This week we examined Alvaro once again. Due to a small change in the keratoconic condition of his corneas it was necessary to refit both of Alvaro’s eyes with new scleral lenses. Today I asked Alvaro how he functioned with his old hard lenses before coming to visit us 7 years ago, he responded that he had poor vision and that his old lenses “hurt like hell”. Before visiting us 7 years ago, Alvaro was told by his doctors back home that he might need to have corneal transplant surgery if he was unable to wear contact lenses. Thanks to his scleral lenses, Alvaro will never need to undergo corneal transplant surgery.