Transcript Sclera Contact Lens Candidate

A Guide to Identifying
Potential Scleral Lens Patients
Sept 20, 2014
Natalie Santelli, MAT, OD
The BIG Picture
• An introduction to
scleral lenses
• Goals of
Treatment
• Indications for
Treatment
• Presenting Scleral
Lenses to Patients
What are scleral lenses?
1508
• Leonardo daVinci
1888
• Adolf Fick Blown Glass “Vessicle”
1888
• Eugene Kalt Glass CTL with KCN
1889
• August Mueller Glass CTL high myopia
1900
• PMMA Scleral Lenses & impression molding
’s
1970’s
• Gas Permeable Scleral Lenses
Gas Permeable Lens Labs
Terminology
Names
Alternative
Names
Corneal
Corneo-Scleral
(Full) Scleral
Diameter
Bearing
8.0 to 12.5 mm All on cornea
CornealLimbal
Semi-Scleral
Limbal
12.5 to 15.0
mm
Haptic
15 to 25 mm
Mini vs Large
(>18 mm)
Scleral
Tear Reservoir
none
Shared b/t
the cornea
and sclera
Limited
capacity
All on Sclera
Somewhat
limited to
unlimited tear
reservoir
capacity
Goals of Scleral Lens Treatment
• Reduce symptoms and support healing by
restoring a healthy ocular surface
environment
• Improve blurry vision by masking surface
corneal irregularities and transmitting a
sharper image to the retina
• Prevent damage by protecting the cornea
against the environment and eyelids
Indications for Scleral Lens Treatment
• Vision Improvement
– Correcting the irregular cornea: Keratoconus, ectasia, post-LASIK,
corneal trauma/infections, post corneal transplants (PKP), high
myopia/hyperopia
• Corneal Protection
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Exposure keratitis/ocular surface disease patients
Sjögren’s Syndrome
Persistent Epithelial Corneal Defects
Steven’s Johnson Syndrome
Graft Versus Host Disease (GVHD)
Ocular Cicatricial Pemphigoid
Neurotrophic Corneal Disease
Atopic Keratoconjunctivitis
• Pharmaceutical Delivery
– Antibiotic coverage while a persistant epithelial defect heals
– Reduce corneal neovascularization with anti-VEGF medications
– Pain mediation with low levels of sodium channel modulators
• Theses next slides will expand upon the
indications for scleral lenses as mentioned in
the previous slide
Keratoconus & Scleral Lenses
Restoring Vision, Restoring Lives
THANK YOU!