Clinical Report: The Scleral Lens Vault: Overnight Scleral Lenses

Overview

Revise to state that while overnight wear is not common, it can be necessary for specific patients with severe ocular surface disease.

Background

The use of scleral lenses overnight is a therapeutic option for patients with severe ocular surface disease, where traditional treatments may not suffice. These lenses can protect the cornea and facilitate healing by maintaining a pre-corneal fluid reservoir. Understanding the implications of overnight wear is crucial for optimizing patient outcomes in challenging cases.

Data Highlights

Key Findings

• Overnight wear of rigid GP scleral lenses can increase corneal swelling by 4.9% to 17.5% compared to no lens wear.
• A regimen of daytime and overnight scleral lens wear promoted healing in 17 of 20 eyes with recurrent epithelial erosion.
• Using moxifloxacin in the lens reservoir helped heal persistent epithelial defects and reduced microbial keratitis rates.
• Case series indicate that scleral lenses can provide faster healing for refractory epithelial defects when used with autologous serum.
• Recommendations include using high-Dk materials and a 12-hour lens removal schedule for disinfection.

Clinical Implications

Highlight the necessity of patient education regarding the risks of overnight lens wear.

Conclusion

Overnight therapeutic scleral lenses represent a valuable option for managing severe ocular surface conditions, with evidence supporting their efficacy in promoting corneal healing.

References

1. Smith GT, Mireskandari K, Pullum KW, Cornea, 2004 -- Corneal Swelling with Overnight Wear of Scleral Contact Lenses
2. Lim P, Ridges R, Jacobs DS, Rosenthal P, Am J Ophthalmol, 2013 -- Treatment of persistent corneal epithelial defect with overnight wear of a prosthetic device for the ocular surface
3. He X, Donaldson KE, Perez VL, Sotomayor P, Optom Vis Sci, 2018 -- Case Series: Overnight Wear of Scleral Lens for Persistent Epithelial Defects
4. Contact Lens Spectrum — The Scleral Lens Vault
5. Contact Lens Spectrum — The Scleral Lens Vault
6. Contact Lens Spectrum — The Scleral Lens Vault
7. Contact Lens Spectrum — The Scleral Lens Vault
8. BostonSight PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) and Scleral Contact Lenses - EyeWiki
9. Case Series: Overnight Wear of Scleral Lens for Persistent Epithelial Defects - PubMed