Clinical Scorecard: GSLS Course Traces the Evolution of Scleral Lenses from 2010 to the Present
At a Glance
| Category | Detail |
|---|---|
| Condition | Irregular astigmatism, keratoconus, ocular surface diseases, post-surgical corneal conditions, severe dry eye disease |
| Key Mechanisms | Scleral lenses vault over the cornea, landing on the conjunctiva; advanced diagnostic and fitting technologies including topography, tomography, and impression-based designs |
| Target Population | Patients with complex ocular conditions including irregular corneas, post-corneal transplant, severe dry eye (e.g., Sjögren’s syndrome) |
| Care Setting | Specialty vision care and contact lens clinics with expertise in scleral lens fitting and management |
Key Highlights
- Significant advancements in scleral lens technology and applications from 2010 to 2025
- Expanded indications including irregular astigmatism, keratoconus, ocular surface diseases, and post-surgical management
- Use of advanced diagnostics and individualized lens materials, coatings, and solutions to optimize patient outcomes and manage complications
Guideline-Based Recommendations
Diagnosis
- Utilize corneal topography and tomography for precise assessment of corneal irregularities
- Employ impression-based lens designs for customized scleral lens fitting
- Screen for coexisting ocular surface conditions such as meibomian gland dysfunction and Demodex infestations
Management
- Fit scleral lenses that vault the cornea and land on the conjunctiva to improve vision and ocular surface protection
- Use multiple lens materials, surface treatments, and solutions tailored to individual patient needs
- Address complications proactively, including midday fogging and front surface non-wetting
Monitoring & Follow-up
- Regular follow-up to assess lens fit, ocular surface health, and symptom relief
- Monitor for signs of inflammation, corneal edema, and transplant rejection in post-surgical patients
- Evaluate tear film stability and manage dry eye symptoms continuously
Risks
- Midday fogging affecting vision and comfort
- Front surface non-wetting leading to lens discomfort
- Inflammation and potential complications related to underlying ocular surface disease or lens wear
- Suction issues and corneal edema in post-surgical patients
Patient & Prescribing Data
Individuals with complex ocular conditions including irregular corneas, ocular surface disease, and post-surgical eyes
Customized scleral lenses improve vision and ocular surface health; success depends on individualized fitting, material selection, and management of coexisting conditions
Clinical Best Practices
- Incorporate advanced diagnostics such as topography and tomography for precise lens fitting
- Proactively identify and treat ocular surface conditions that may impact lens wear success
- Customize lens materials and surface treatments based on patient-specific needs
- Educate patients on potential complications and strategies to mitigate them
- Use case-based approaches to tailor scleral lens management for diverse ocular conditions
References
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