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What other corneal conditions can benefit from scleral lenses?

Besides keratoconus, there are several other corneal conditions or dystrophies that can benefit from the use of scleral contact lenses. Most of these disorders cause an irregular corneal surface which induces irregular astigmatism, blurred vision, ghost images, and vision not correctable by glasses or standard contact lenses.  Scleral contact lenses completely cover these irregular corneal surfaces, providing a smooth optical surface and increased clarity to maximize vision. Scleral lenses rest on scleral (white part of the eye) which has minimal nerve ending making them much more comfortable than rigid gas permeable or other types of contact lenses. Many of these corneal disorders can often be painful and can be aggravated by eyelid interaction with the cornea. Scleral contact lenses completely cover the cornea and protect it from the eyelid friction. Here is a list of corneal disorders that can benefit from scleral contact lens treatment.

  • Salzman’s Nodular Dystrophy
  • Sjögren’s syndrome
  • Neurotrophic Keratopathy
  • Ocular cicatricial pemphigoid
  • Terrien’s marginal degeneration
  • Keratoglobus
  • Dry eye syndrome

Post Refractive Surgery uses of Scleral Contact Lenses

Refractive surgeries procedures such as LASIK, PRK, RK and SMILE which reduce the need for glasses and contact lenses have become very popular and successful in recent decades. However, for the small percentage of refractive surgery patient that have complications, finding treatment can be difficult. The two most common complications from refractive surgery are post-surgical blur and dry eye. Scleral lenses can be of benefit in both of these areas.

Post-refractive surgery blur not correctable by glasses or standard contact lenses is called corneal ectasia and is very similar to keratoconus. Most refractive surgery procedures involve the use of a laser to thin the cornea and move the eye’s focus into the proper position on the retina. This thinning can cause the cornea to destabilize and warp resulting in irregular astigmatism and vision that is not correctable by glasses or standard contact lenses. Similar to their use in treating keratoconus and other corneal disorders, scleral contact lenses cover this uneven corneal surface allowing for correctable, clear vision.

Post refractive surgery dry eye and dry eye problems in general can benefit great from scleral contact lens treatment.  Refractive surgery results in the severing of nerve endings that stimulate tear production which can lead to dry eye syndrome.  Many other factors not involving refractive surgery can also lead to dry eye. Lubrication drops, Xiidra, and Restasis  can often give some relief to dry eye but are often quite expensive and must be used on a regular basis to be effective.  Scleral contact lenses completely cover the cornea preventing tear evaporation and also keep a thin layer of saline against the cornea keeping it hydrated. This results in improved dry eye symptoms and reduced the need for lubrication drops other dry eye therapies.