Clinical Scorecard: CL Leaders Present Insights on the Modern Era of Scleral Lenses
At a Glance
| Category | Detail |
|---|---|
| Condition | Visual correction with scleral lenses |
| Key Mechanisms | Scleral lenses provide comfort and vision correction by vaulting the cornea and resting on the sclera, affecting corneal physiology and ocular structures dynamically |
| Target Population | Patients with varying visual histories including long-term rigid lens wearers and new scleral lens users |
| Care Setting | Specialty lens practice and clinical follow-up settings |
Key Highlights
- Patient expectations vary widely; managing expectations before fitting is critical for satisfaction.
- Dynamic, longitudinal assessment of scleral lens fit, vision, and eye health is essential due to physiological changes over time.
- Further research is needed to understand mechanical and suction-related effects of scleral lenses on ocular structures during wear.
Guideline-Based Recommendations
Diagnosis
- Assess patient’s visual history and baseline correction before scleral lens fitting.
- Perform full dilated eye exams as indicated after scleral lens removal.
Management
- Educate patients thoroughly about realistic outcomes prior to lens delivery.
- Monitor scleral lens fit and vision dynamically over time, not just at initial fitting.
Monitoring & Follow-up
- Regular follow-up examinations to assess corneal physiology, inflammation, and optic nerve health.
- Examine the eye after lens removal to detect any adverse effects.
Risks
- Potential conjunctival compression and changes in iris position, crystalline lens, and anterior chamber angle during lens wear.
- Unrealistic expectations may lead to dissatisfaction, especially in monocular patients or those with excellent baseline vision.
Patient & Prescribing Data
Long-term rigid lens wearers and new scleral lens users with poor vision in glasses
Long-term rigid lens wearers may experience improved comfort but variable visual performance; new users with poor vision often have more modest expectations and higher satisfaction.
Clinical Best Practices
- Set clear, realistic expectations with patients before scleral lens fitting.
- Adopt a dynamic, longitudinal approach to monitoring lens fit, vision, and ocular health.
- Instruct patients on the importance of regular follow-up to maintain eye health and vision.
- Conduct comprehensive eye exams including dilated exams as clinically indicated after lens removal.
References
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