September 2012 Online Photo Diagnosis

By Gregory W. DeNaeyer, OD, FAAO

Figure 1 shows the right scleral lens of a 75-year-old female who fell and hit her right eye while wearing the lens. The trauma ruptured her 11-year-old full-thickness corneal transplant. The patient reported to our office with the scleral contact lens already out of her eye. The lens was intact without any cracks or chips. She had emergency surgery to repair the wound.

The corneal transplant of her right eye 11 years prior to the injury was for Fuchs' corneal dystrophy. Her transplant was clear, but she was able to achieve only 20/100 best-corrected visual acuity with a glasses prescription secondary to corneal irregularity. She was successfully fit with a scleral contact lens that improved her visual acuity to 20/30 (Figure 2).

The patient continues to recover and her prognosis is unknown.