On Saturday, Jan. 18, at the 2025 Global Specialty Lens Symposium (GSLS), a course titled “Scleral Lenses: From 2010 to the Present” explored the dramatic advancements in scleral lens technology and applications over the past 15 years. This session highlighted the transformative impact of these lenses on vision care, especially for individuals who have complex ocular conditions.

Moderated by Maria Walker, OD, PhD, the expert panel of speakers included Jennifer Fogt, OD, MS, assistant professor at Ohio State University; Zanna Kruoch, OD, associate professor at the Rocky Mountain University of Health Professions; Chad Rosen, OD, professor at the Michigan College of Optometry; and Vishaka Thakrar, BSc, OD, director of the Vaughan Vision Centre.

The course reviewed the history and evolution of scleral lenses, outlining significant developments between 2010 and 2025. Attendees examined how practitioner confidence and patient awareness of scleral lenses had grown, leading to an expanded range of indications. These included addressing irregular astigmatism, keratoconus, ocular surface diseases, and post-surgical conditions such as corneal transplants.

Speakers presented case-based discussions, showcasing successful fittings for various conditions, from “normal” corneas to severe irregularities. They explained that modern scleral lenses are designed to vault over the cornea and land on the conjunctiva, and advanced diagnostic and fitting technologies, such as topography, tomography, and impression-based lens designs, were emphasized.

The course also covered the use of scleral lenses in managing dry eye disease, particularly in severe cases like Sjögren’s syndrome. Studies highlighted the effectiveness of these lenses in alleviating symptoms and improving tear film stability. Complications such as midday fogging were discussed, with insights into how lens materials, coatings, and solutions could mitigate these challenges. Additionally, in-depth analyses revealed the role of scleral lenses in post-surgical management, addressing unique complications such as corneal edema, transplant rejection, and suction issues.

“Patients who wear scleral lenses often have multiple eye conditions that can play a role in their success with lens wear. Our understanding of lens fitting and the benefit of having multiple lens materials, surface treatments, and solutions, can help us to give individualized care to our patients,” says Dr. Fogt. “This is important when we are considering problems like midday fogging, front surface non-wetting, inflammation, and other problems that can hinder success. For example, we may be fitting patients due to an irregular cornea, but we must be proactively searching for conditions such as meibomian gland dysfunction or Demodex infestations, which can commonly contribute to scleral lens complications.”