This is a photo of me with my patient Ricardo, who has been visiting our practice from Guatemala for the past 10 years on a yearly basis for his annual eye examinations. About 30 years ago, Ricardo underwent Radial Keratotomy surgery in both eyes. While his vision at first was quite good for the first few years, his vision gradually started to deteriorate. When I first met Ricardo, he was wearing eyeglasses which were providing him with 20/100 vision with a lot of visual distortions. He tried to wear various contact lens designs which were either uncomfortable or were unable to provide him with functional vision. 10 years ago, we fit Ricardo with GVR Scleral lenses. With these lenses Ricardo has clear (20/20) vision both at distance and close up and is able wear his lenses all day comfortably. Over the past 10 years we have only had to make a few changes to his scleral lenses. The 2nd photo seen below shows a close up view of Ricardo’s open RK incisions. Note the blood vessel growth along the incisions. The last image was taken with a technology known as “Optical Coherence Tomography” or OCT. In this image the top 2 curves lines represent the front and back surfaces of the scleral lens. The large grey structure going left to right is the cornea. Note the wide, open break in the cornea on the right side of the image. This is an open RK incision that will never heal. Ricardo’s scleral lens protects this eye from the blinking action of the eyelids and from the environment. In addition, because of the liquid reservoir between the back surface of the lens and the front surface of the cornea, Ricardo’s eye is always in a moist environment. I expect Ricardo to be able to wear his scleral lenses for many years with excellent comfort and vision.