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Dr. Edward Boshnick |
Frequently asked questions about scleral lensesI have keratoconus. Should I consider scleral lenses? Keratoconus is a challenging disease that affects each patient in a unique manner. Most keratoconic patients can wear special gas permeable lenses quite well. However, if the keratoconus is very advanced, or if the corneal tissue is compromised, corneal gas permeable lenses may not be tolerated well. In situations such as these, scleral lenses usually work very well. Why do scleral lenses work well with keratoconus? Scleral lenses do not touch or rest on the irritated corneal tissue. Instead these lenses vault over the cornea and are supported by the white portion (the sclera) of the eye. A special fluid fills the space between the back portion of the lens and the front of the cornea. There is very little lens movement and the edges of the lens are beneath the eyelids. Due to the increased stability of these lenses over conventional gas permeable lenses, comfort and vision is usually excellent. In addition, the fluid environment between the back of the lens and the front of the cornea tends to promote healing of the irritated corneal tissue. My doctor says that my keratoconus is mild yet I can't seem to tolerate my contact lenses and the vision with my glasses is getting worse. My doctor has tried everything. Will scleral lenses work for me? The use of scleral lenses in keratoconus is not related to the severity of the disease. Patients with mild keratoconus can be fitted with gas permeable scleral lenses. My keratoconus is very advanced. I see well with my contact lenses but one lens pops out 6 or more times a day and I can only wear the other lens for a few hours because it hurts. My doctor says that this is the best fit that I can get. Can scleral lenses help me? Your doctor's response is not unusual. Doctors often associate scleral contact lenses with the poorly tolerated scleral lenses that were used 50 or 60 years ago. The gas permeable scleral lenses of today are made of highly oxygen permeable materials that provide excellent comfort and vision. In fact, patients with a number of corneal diseases actually undergo a healing affect after scleral lens wear. The scleral lenses create a reservoir of fluid that bathes the corneal surface while the lenses are worn. This often reduces the pain and light sensitivity that can be debilitating to patients with corneal diseases such as Stevens-Johnson Syndrome, post-lasik surgery, post-corneal transplants, corneal ectasia, keratoconus and so on. |
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