Indications

Indications for a Scleral Lens

Initially these prosthetic devices were just used for extremely irregular corneas when a traditional smaller RGP lens was not successful.

Over the last several years, the indications for Scleral lenses have expanded greatly.

 

Examples:

  • Primary corneal ectasias (thinning disorders)
  1. Keratoconus
  2. Keratoglobus
  3. Pellucid Marginal Degeneration
  • Secondary ectasias resulting from refractive surgery
  1. RK- Radial Keratotomy
  2. PRK – photorefractive keratectomy
  3. Lasik – Laser assisted in-situ keratomileusis
  4. Lasek – Laser assisted epithelial keratoplasty)
  • Trauma
  1. Chemical Injury
  2. Burn Injutry
  • Corneal Transplant  (Full or partial thickness)
  • Cornea Scars
  1. Trauma or infections (ie Herpes Simplex)
  • Corneal Degenerations
  1. Terrien’s Marginal Degeneration
  2. Salzmann’s Nodular Degeneration
  • Corneal Dystrophies (anterior) that significantly distort the cornea
  1. Map-Dot (Cogan’s)
  2. Reis-Buckler

 

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More recently, these large lenses that vault the cornea, bathing the ocular surface in fluid, have been successful in treating patients with exposure or severe ocular surface disease assisting the tissue to heal.

 

Examples:

  • Ocular Surface Disease / Severe Dry Eye    (which can occur with these conditions)
  1. Graft vs Host Disease
  2. Sjorgren’s Syndrome
  3. Persistent epithelial defects
  4. Steven’s Johnson Syndrome
  5. Cicatricial Pemphigoid
  6. Neurotrophic Ulcers
  7. Atopic Keratoconjunctivitis
  • Exposure issues (when there is incomplete Lid Closure.)
  1. Eyelid Coloboma
  2. Ectropion
  3. Post Lid Surgery
  4. Exophthalmus
  5. Nerve Palsies
  • Ocular Surface Protection   (other)
  1. Trichiasis
  2. Entropion

 

  • Some other creative indications
  1. Symblepharon (to maintain the fornix)
  2. Novel drug delivery system
  3. High refractive Corrective errors (not successful with other lenses)
  4. Prism incorporation (vertical and horizontal as these lenses are very stable)
  5. Vigorous Sports

 

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On occasion there may be unusual distortion of the entire global surface. Some examples are from a Scleral Buckle procedure (retinal detachment) or a Filtering Bleb for glaucoma.

These situations may require a custom mold of the entire eye surface.

We are a certified EyePrint Prosthetic provider to satisfy these conditions.

For more information:  www.eyeprintpro.com