Why is it so Hard for Doctors to Get it Right when it comes to Fitting High-Need Patients with a Specialty or 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.