Tag Archive for: scleral lens

Remember when you were a child and you played with a magnifying glass? The glass focused light to a point because its surface was smooth. Imagine the surface was instead pitted or grooved or ridged. Light would no longer focus to a point, it would be smeared or distorted in some unpredictable way, depending on the exact irregularities in the glass. These are called higher-order aberrations.

The same is true of a human cornea that has been damaged by eye injury or by refractive surgeries like Lasik or PRK. If these corneas are not regular, light no longer focuses sharply on the macula, even with glasses or contact lenses. In this case, a scleral lens can restore vision by acting as a prosthetic cornea that provides a smooth anterior surface.

The image below illustrates the reduction in higher-order aberrations before and after a 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.

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.