The Healing Power of the Scleral Lens

The two photos below are of the left eye of a patient who suffered significant trauma to his body, face and left eye in a car accident. This patient’s upper left eyelid was severed from flying glass. His left cornea had numerous particles of glass which nearly perforated his cornea, but did create a purulent corneal ulceration. Two months ago reconstructive surgery was performed on this patient’s left upper eyelid. One month ago I fit this eye with a scleral lens to protect it from the environment and the blinking action of the eyelid. 7 days ago I refit this eye with a very thin gas permeable scleral lens made with a highly oxygen permeable material that is FDA approved for wear during sleep. Because this patient is unable to close his left eye completely, I asked him to wear this lens during sleeping hours as well as during the his waking hours. He has been wearing this lens all day while taking short breaks during the day to remove the lens, rinsing out his eye with saline solution, cleaning the lens and reinserting it. Look carefully at the photos below. The first photo was taken one month ago when I first met this patient and placed a scleral lens on this eye. Note the inflammation, mucous formations and the opaque, cloudy cornea. At the initial visit, this patient’s best corrected visual acuity was finger counting. The 2nd photo was taken yesterday. Note how much clearer his cornea is. In the 2nd photo you can see his pupil which is barely visible in the first photo. Also note the improved appearance of his upper eyelid in the 2nd photo. With this very thin highly oxygen permeable scleral lens, this patient’s corrected visual acuity is now 20/150. The oculoplastic surgeon who I share this patient with was as surprised as i was at the degree of improvement in such as short period of time. Three months before I met this patient, he was told by a very prominent eye specialist that this eye needed to be removed. Fortunately he and his family decided to obtain another opinion. This patient’s story, his eye and his scleral lens “journey” with me has to be one of the most unforgettable experiences of my career.