This is a very rare photo of an extremely rare event. You are looking at a scleral lens over an eye with Stevens Johnson Syndrome. This eye is the patient’s only functioning eye. For 10 years this patient wore a scleral lens over this eye without any problems until the cornea perforated several years ago. A corneal transplant operation was performed as a medical emergency. Several months later we fit this eye with a scleral lens which is providing this patient with clear (20/20) comfortable vision once again. The arrow at the top is pointing to the edge of the scleral lens. This is another example of how a well designed and fit scleral lens can change a patient’s life.
Stevens Johnson Syndrome is a rare, life threatening disorder of the skin and mucous membranes. It is usually caused by a reaction to medication or infection. It often begins with flu-like symptoms followed by a painful red or purplish rash that spreads and blisters. Stevens Johnson Syndrome is a medical emergency that usually requires hospitalization. The rash caused by Stevens Johnson Syndrome can lead to inflammation and scarring of the cornea, conjunctiva and the eyelids of the eye. The extensive tissue damage caused by Stevens Johnson Syndrome can result in severe visual impairment and even blindness.
Over the years we have treated many patients who have lost vision and ocular comfort due to Stevens Johnson Syndrome. Typically the ocular surfaces of a Stevens Johnson Syndrome eye are severely inflamed, partially or totally opaque, very dry and distorted. In addition, these eyes are a usually very painful and the patients are often so light sensitive that they often wear sunglasses indoors and at night. Very often connective tissue develops in these eyes that will connect the lining of the eyelids to the conjunctiva and/or the cornea. In order to protect the compromised ocular surface from the environment and the blinking action of the eyelids, the standard of care for the restoration of vision and ocular comfort is to fit these eyes with a well designed gas permeable scleral lens. A scleral lens will not touch the traumatized ocular surface. Instead, this unique lens will vault over the cornea and rest on the white portion of the eye known as the sclera. The space between the back surface of the scleral lens and the front surface of the cornea will keep the dry, traumatized cornea is a wet environment and protect it from the environment and the blinking action of the eyelids. In addition, the scleral lens will prevent tissue from the eyelids from adhering to the cornea and conjunctiva. Almost always a well designed scleral lens will eliminate the patient’s light sensitivity and greatly improve the Stevens Johnsons Syndrome patient’s visual acuity.
Dr. Edward Boshnick maintains a cutting edge practice devoted to the restoration of vision and comfort lost as a result of refractive eye surgery (including LASIK and Radial Keratotomy), keratoconus, corneal transplant surgery, pellucid marginal degeneration, extreme dry eye, corneal dystrophies, corneal trauma, lasik damage and Stevens-Johnson Syndrome.
A few words about Dr. Edward Boshnick and his eye care practice:
Dr. Edward Boshnick maintains a cutting edge optometric practice covering all types of vision care including non-surgical vision improvement, contact and scleral lens care, children’s vision and vision rehabilitation for the partially sighted. Dr. Boshnick received his B.A. degree from the University of Miami and his Doctorate degree was awarded in Optometry from Southern College of Optometry.