Bullous Keratopathy in Keratoconus Treated with GVR Scleral Lens

The patient standing next to me was diagnosed with keratoconus many years ago. Standing next to her is her husband. When she first visited our office we immediately saw that she had an advanced case of keratoconus. The year before we met her she underwent cataract surgery in both eyes and also Collagen Cross Linking therapy in both eyes. The keratoconus in her left eye was so advanced that the outer cellular layer of her left cornea (the epithelium) was separating from the underlying corneal tissue, a condition known as bullous keratopathy. Over the years this patient was fit with a variety of gas permeable lenses which caused her significant discomfort and often pain. In addition her lenses would often pop out of her eyes at the most inconvenient times. When this patient first visited our office her visual acuity was 20/150 with her corrective lenses. In 2012, we fit both eyes with GVR Scleral lenses which are allowing her to 20/25 with all day comfort. Since we first met this very nice lady, her vision and her corneas have remained stable. I expect her to be able to wear her lenses comfortably and with clear vision for many years to come. In the lower photograph is a profile photo of her left cornea. Both corneas have similar topographies. The center of gravity of this cornea is so far out that any small gas permeable lens placed on its surface will be unstable, uncomfortable and likely pop out. The scleral lenses that we fit her with do not touch her corneas but rather vault over her corneas and rest on the white portion (the sclera) of her eyes. The space between the back surface of the lenses and the front surface of her corneas is filled with unpreserved sterile saline solution so that her dry, irritated corneas will always be in a wet environment.

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Optimum Infinite Gas Permeable Material

I am happy to announce that our Global Vision Rehabilitation Center will be designing and fitting all of our “high need” patients with the Optimum Infinite gas permeable contact lens material. The Optimum Infinite material is the most oxygen permeable material ever to be approved by the FDA. In addition, this newly FDA approved material includes a UV lens blocker. Now for the first time, with certain patients, wearing a scleral lens made with the Infinite material under extended wear conditions can be considered.

SMAP 3D Scleral Lens Design

NEW: Powerpoint presentation on SMAP 3D

Last year we introduced an exciting piece of technology that has allowed us to custom design a scleral lens much more accurately. It is the SMAP 3D, which is a computer attached to a dedicated camera that allows us to obtain a 3 dimensional image of the entire front surface of the eye, including the cornea and the surrounding white portion of the eye (the sclera). Up until now there has not been any technology that would allow us to measure the ocular curvatures outside the cornea. The SMAP allows us to do this. Read More

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EyePrint Pro

EyePrintPro technology creates a scleral lens based on a mold of the cornea. The molding is accurate to 1 or 2 microns and fits perfectly because it exactly mirrors the irregularities of the individual corneal surface. The technology is well suited for post-Lasik, Keratoconus, RK, eye injury, and corneal transplant patients. Read More in this PDF about EyePrintPro Scleral Lens Technology

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