Online Photo Diagnosis

By: JASON JEDLICKA, OD

Contact Lens Spectrum September 1, 2025 Vol 40, Issue September 2025 Page(s): 2

Clinical Report: Online Photo Diagnosis of Scleral Lens Complications

Overview

A 25-year-old female developed peripheral corneal epithelial bullae due to inadequate vaulting of her scleral lenses. Refitting with a larger diameter lens resolved the issue, highlighting the importance of proper lens fitting.

Background

Scleral lenses are increasingly used for refractive error correction, but improper fitting can lead to complications such as epithelial bullae. Understanding the mechanical nature of these bullae is crucial for timely intervention to prevent long-term corneal damage.

Data Highlights

No numerical data was provided in the source material.

Key Findings

Peripheral corneal epithelial bullae can occur with scleral lens wear due to mechanical compression.
Inadequate vaulting leads to lenses landing on the peripheral cornea, causing bullae formation.
Refitting with a larger diameter lens is essential to resolve mechanical bullae.
Symptoms may not be present initially but can worsen over time, necessitating immediate refitting.
Current fitting guidelines emphasize adequate corneal clearance and aligned landing zones to prevent complications.

Clinical Implications

Clinicians should ensure proper fitting of scleral lenses to avoid complications such as epithelial bullae. Immediate refitting with a larger diameter lens is recommended upon discovery of mechanical compression, regardless of symptom presence.

Conclusion

Proper fitting of scleral lenses is critical to prevent mechanical complications. Timely intervention can preserve corneal health and improve patient outcomes.

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