SCLERAL LENSES FOR NORMAL CORNEAS

Since 2006, scleral contact lenses have exploded in the contact lens industry. The largest area of growth that the gas permeable industry has seen in years has taken place in the scleral lens category.

Figure 1.

The idea of scleral lenses is not a new one. Scleral lenses were first used in the late 1800s and early 1900s and were made of blown glass. Glass is not a material conducive to oxygen transmission, was difficult to work with and was certainly not a safe material to be wearing directly over the cornea. The development of polymethylmethracrylate (PMMA) made the lenses a bit safer and was slightly easier to manufacture than glass, but still did improve oxygen transmission. The emergence of corneal lens designs that utilized the tear pump to improve oxygen delivery to the cornea moved eyecare professionals (ECPs) away from scleral lens designs.

Over the past decade, ECPs have started to reconsider scleral lens designs as an option for their contact lens patients. Improved materials and better technology for fitting and manufacturing scleral lenses are key factors contributing to the rebirth of these lenses.

Table 1.

At first, practitioners seemed to only consider a scleral lens design when all else failed. Over time, that trend seems to be changing. Scleral lenses offer some distinct advantages to wearers, including but not excluded to superb comfort, stability of fit and excellent vision. Now that we have super Dk materials with excellent oxygen transmissibility, tools such as topography and optical coherence tomography (OCT) and computer numeric controlled (CNC) lathes to produce and reproduce scleral lenses, practitioners have started using scleral lenses for normal cornea applications.

Since 2006, scleral contact lenses have exploded in the contact lens industry. The largest area of growth that the gas permeable industry has seen in years has taken place in the scleral lens category. This article will define scleral lenses, describe their advantages and provide information designed to help ECPs decide whether scleral lenses may be a good fit for their practice.