Contact Lens Case Report: Scleral Lenses With Wavefront Optics

This case highlights a patient who had corneal ectasia and was able to achieve improved visual acuity with a scleral lens that included wavefront optics to correct for residual HOAs.

By: Gregory W. DeNaeyer, OD, FAAO

Contact Lens Spectrum May 1, 2025 Vol 40, Issue May 2025 Page(s): 36

Clinical Report: Scleral Lenses With Wavefront Optics

Overview

Revise to specify initial challenges with HOAs and detail the nature of visual improvement.

Background

Corneal ectasia can severely impact visual acuity, often leaving patients dissatisfied with conventional corrective lenses. Scleral lenses are increasingly recognized as a first-line option for managing irregular astigmatism, particularly in cases where standard optics fail to address residual HOAs. The integration of wavefront optics into scleral lens design represents a promising advancement in visual rehabilitation for these patients.

Data Highlights

Parameter	Initial	Post-Wavefront Correction
Visual Acuity OD	20/300	20/25
Visual Acuity OS	20/300	20/25
Residual HOAs	Significant	Reduced

Key Findings

A 52-year-old female with corneal ectasia improved visual acuity from 20/300 to 20/25 with wavefront-corrected scleral lenses.
Initial scleral lenses provided significant visual improvement but residual HOAs persisted.
Front-surface eccentricity worsened visual acuity in this case.
Wavefront correction effectively reduced residual HOAs, enhancing visual performance.
Seventeen out of 18 patients in a related study preferred wavefront-corrected lenses over traditional options.

Clinical Implications

Identify specific patient profiles that may benefit from wavefront-corrected lenses.

Conclusion

The case illustrates the potential of wavefront optics in scleral lens design to enhance visual outcomes for patients with complex corneal conditions. Continued exploration of customized optical solutions is essential for optimizing patient care.

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