Fitting Scleral Lenses

E2
ICLC 2020

© The International Association of Contact Lens Educators

April 2020 www.iacle.org
Attributions

Original contributors and authors of the Patrick Caroline, Beth Kinoshita,

lecture Matthew Lampa, Maria Walker

Lecture editor (2015-16) Luigina Sorbara

Lecture reviewer (2020) Eef van der Worp

Lecture updated on April 2020

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Official Scleral Lens Terminology

• 2019

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Official Scleral Lens Terminology

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Official Scleral Lens Terminology

• Scleral Lens (SL)

• Not ‘contact’ lens
• The New Terminology removes the distinction between
‘mini’ and ‘large’ scleral lenses
• All Scleral Lenses – regardless of size - are fitted to
completely vault over the cornea and land on the
conjunctiva
• ‘Application’ of scleral lenses is used instead of
‘Insertion’
• To describe the difference in shape and height of the
ocular surface the term ‘asymmetry’ is used

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Scleral Lens Diameter

’…65% prescribing lenses of average diameter (15-17mm),

… 18% fitted smaller than 15mm lenses
… 17% fitted larger than 17mm lenses.’

‘survey based on 84.000 lens fits’

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Oxygen

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Oxygen

• Minimal requirements according to Michaud et al

CONTACT LENS & ANTERIOR EYE 35 (2012) 266– 271

clearance
200 micron

material
Dk 150 >

center thickness
250 micron

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Scleral CL Comfort: A Comparison of 2 Designs

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Benefits of Scleral Lenses
vs Corneal Lenses

SCLERALS
• Bypassing most sensitive part of the eye
• Lens fit independent from corneal shape
• No 3 - 9 O’ clock staining
• Prevents eye-rubbing
• Progression underneath lens in KC
• Less movement (comfort)

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Scleral Lens Publications: Pubmed search

Rute Juliana Ferreira Macedo de Araújo

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Complications

MICROBIAL KERATITIS

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Complications

MICROBIAL KERATITIS

For corneal GPs this is 1 on 10.000 lens wear years (0.01%)’. For
DW soft this is 5 on 10.000 lens wear years (0.05%)’.

‘incidence’ of 0.1% for infections with scleral lenses?

‘survey based on 84.000 lens fits’

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Complications

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Complications

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Scleral Lens Complications

• 2019

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Scleral Lens Complications

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Intra Ocular Pressure

These results suggest that, as evaluated with a non-standard transpalpebral

methodology, IOP during scleral lens wear may be increased in average by 5 mm Hg,
regardless of the lens diameter. More work is needed to confirm if practitioners
should be warned when using SL on populations at risk for glaucoma.

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A Scleral Lens Special – Contact Lens & Anterior Eye

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Resources

http://commons.pacificu.edu/mono/4/ http://commons.pacificu.edu/mono/10/

http://commons.pacificu.edu/mono/4/

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Resources

Scleral Lens Case Report Series

http://commons.pacificu.edu/mono/5/

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Resources

Clinical Guide for Scleral Lens Success

https://www.scleralsuccess.com

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Resources

Contemporary Scleral Lenses:

Theory and Application
Melissa Barnett, Lynette K. Johns

https://ebooks.benthamscience.com/book/9781681085661/

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Feedback on errors, omissions, or suggestions for
improvement are invited. Please contact us at:
iacle@iacle.org

See the following slides explaining the symbols,

abbreviations, and acronyms used in the IACLE
Contact Lens Course

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Symbols

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Abbreviations

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Acronyms

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Acronyms

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