SCLERAL LENSES: Understanding Applications and Maximizing Success

October 2016 supplement to Contact Lens Spectrum

Scleral Lenses: Past & Present
By Jason Jedlicka, OD

    1. Bowden TJ. Contact Lenses: The Story. Kent: Bower House Publications; 2009.

    2. Fick AE. A contact lens. Arch Ophthalmol. 1997;115(1):120-121.

    3. Müller A. Brillengläser und hornhautlinsen. Inaugural Dissertation;20. 1889; University of Kiel.

    4. Pearson RM. August Müller’s inaugural dissertation. J Br Contact Lens Assoc. 1978;1(2):33-36.

    5. Anderson JM. Contact Lenses: Clinical and other observations, p. 11. Brighton: Courteney Press; 1952.

    6. Ezekiel D. Gas permeable haptic lenses. J Br Contact Lens Assoc. 1983;6(4):158-161.

    7. Pullum KW, Buckley RJ. A study of 530 patients referred for rigid gas permeable scleral contact lens assessment. Cornea.1997;16(6):612-622.

    8. Pullum KW, Whiting MA, Buckley RJ. Scleral contact lenses: the expanding role. Cornea. 2005;24(3):269-277.

    9. Schein OD, Rosenthal P, Ducharme C. A gas-permeable scleral contact lens for visual rehabilitation. Am J Ophthalmol. 1990;109(3):318-322.

    10. Barr JT, Zadnik K, Wilson BS. Factors associated with corneal scarring in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study. Cornea. 2000;19(4):501-507.

Scleral Lenses for Healthy Eyes: A World of Opportunities
By Langis Michaud, OD, MSc

    1. Van der Worp E, Bornman D, Ferreira DL, Faria-Ribeiro M, Garcia-Porta N, González-Meijome JM. Modern scleral contact lenses: A review. Cont Lens Anterior Eye. 2014;37(4):240-250.

    2. Alipour F, Kheirkhah A, Jabarvand Behrouz M. Use of mini scleral contact lenses in moderate to severe dry eye. Cont Lens Anterior Eye. 2012;35(6):272-276.

    3. Michaud L, Barriault C, Dionne A, Karwatsky P. Empirical fitting of soft or rigid gas-permeable contact lenses for the correction of moderate to severe refractive astigmatism: a comparative study. Optometry. 2009;80(7):375-383.

    4. DeNaeyer G. Scleral lens decentration. Presented during the 2014 Global Specialty Lens Symposium in Las Vegas.

    5. Jones L, Brennan NA, González-Méijome J, et al; members of the TFOS International Workshop on Contact Lens Discomfort. The TFOS International Workshop on Contact Lens Discomfort: report of the contact lens materials, design, and care subcommittee. Invest Ophthalmol Vis Sci. 2013;54(11):TFOS37-70.

    6. Segal O, Barkana Y, Hourovitz D, et al. Scleral contact lenses may help where other modalities fail. Cornea. 2003;22(4):308-310.

    7. Schornack MM. Scleral lenses: a literature review. Eye Contact Lens. 2015;41(1):3-11.

    8. Compañ V, Oliveira C, Aguilella-Arzo M, Molla S, Peixoto-de-Matos SC, Gonzalez-Meijome JM. Oxygen diffusion and edema with modern scleral rigid gas permeable contact lenses. Invest Ophthalmol Vis Sci. 2014;55(10):6421-6429.

    9. Ng LH, Wang Z, Chan C-Y, Yueng W-N. Corneal physiological changes after short-term scleral lens wear. Presented during the BCLA meeting, Liverpool, UK, 2015.

    10. Miller WL, Vance K, Johnson L, Bergmanson JPG. Scleral contact lens effects on central and peripheral corneal thickness. Investigative Ophthalmol Vis Sci. 2015;56:6103. ARVO meeting abstract available at: http://iovs.arvojournals.org/article.aspx?articleid=2336208&resultClick=1

    11. Michaud L, van der Worp E, Brazeau D, Warde R, Giasson CJ. Predicting estimates of oxygen transmissibility for scleral lenses. Cont Lens Anterior Eye. 2012;35(6):266-271.

    12. Giasson CJ, Morency J, Michaud L. Measuring oxygen levels under scleral lenses of different clearances. Invest Ophthalmol Vis Sci. 2015;56:6074. ARVO meeting abstract available at: http://iovs.arvojournals.org/article.aspx?articleid=2336175&resultClick=1

    13. Lau J, Reeder R. Localized corneal graft rejection from scleral lens wear with excessive limbal clearance. Presented during the Global Specialty Lens Symposium in Las Vegas, 2015.

    14. Ryff B, Lasby A, Pack L. Corneal decompensation after scleral lens wear in a compromised cornea. Presented during the Global Specialty Lens Symposium in Las Vegas, 2015.

    15. Vincent SJ, Alonso-Caneiro D, Collins MJ, et al. Hypoxic corneal changes following eight hours of scleral contact lens wear. Optom Vis Sci. 2016;93(3):293-299.

    16. Chalmers RL, Young G, Kern J, Napier L, Hunt C. Soft contact lens-related symptoms in North America and the United Kingdom. Optom Vis Sci. 2016;93(8):836-847.

    17. Rumpakis J. New data on contact lens dropouts: an international perspective. Rev Optom. 2010;147(1):37-42.

    18. Schlanger JL. A study of contact lens failures. J Am Optom Assoc. 1993;64(3):220-224.

    19. Weed K, Fonn D, Potvin R. Discontinuation of contact lens wear. Optom Vis Sci. 1993;70(12s):140.

    20. Pritchard N, Fonn D, Brazeau D. Discontinuation of contact lens wear: A survey. Int Contact Lens Clin. 1999;26(6):157-162.

    21. Young G, Veys J, Pritchard N, Coleman S. A multi-centre study of lapsed contact lens wearers. Ophthalmic Physiol Opt. 2002;22(6):516-527.

    22. Richdale K, Sinnott LT, Skadahl E, Nichols JJ. Frequency of and factors associated with contact lens dissatisfaction and discontinuation. Cornea. 2007;26(2):168-174.

    23. Dumbleton K, Woods CA, Jones LW, Fonn D. The impact of contemporary contact lenses on contact lens discontinuation. Eye Contact Lens. 2013;39(1):92-98.

    24. Whitmore WG, Curtin BJ. The optics of myopia. In: Duane’s Ophthalmology. Philadelphia: Lippincott Williams & Wilkins; 2006. Available at: http://oculist.net/downaton502/prof/ebook/duanes/pages/v1/v1c042.html

    25. Hickson-Curran S, Brennan NA, Igarashi Y, Young G. Comparative evaluation of Asian and white ocular topography. Optom Vis Sci. 2014;91(12):1396-1405.

    26. Cho P, Cheung SW, Charm J. Visual outcome of Soflens Daily Disposable and Soflens Daily Disposable for Astigmatism in subjects with low astigmatism. Clin Exp Optom. 2012;95(1):43-47.

    27. Richdale K, Berntsen DA, Mack CJ, Merchea MM, Barr JT. Visual acuity with spherical and toric soft contact lenses in low- to moderate-astigmatic eyes. Optom Vis Sci. 2007;84(10):969-975.

    28. Ramdass S, Rosen C, Norman C, Buckingham R. A clinical analysis of scleral lenses on regular corneas. Presented during the 2016 Global Specialty Lens Symposium in Las Vegas.

    29. Barnett M. 10 Tips for Smarter Scleral Lens Fitting. Review of Cornea & Contact Lenses; October 2012.

    30. Multi-sponsor Surveys, Inc. 2015 Gallup Study of the U.S. Consumer Contact Lens Market. October 2015; Princeton, NJ.

    31. Barnett M. Multifocal Scleral lenses. A look at available lenses that can help our presbyopic patients. Contact Lens Spectrum; December 2015.

    32. Shaker M, Salcone E. An update on ocular allergy. Curr Opin Allergy Clin Immunol. 2016;16(5):505-510.

    33. Leonardi A, Castegnaro A, Valerio AL, Lazzarini D. Epidemiology of allergic conjunctivitis: clinical appearance and treatment patterns in a population-based study. Curr Opin Allergy Clin Immunol. 2015;15(5):482-488.

    34. Altman B. Injury of a mini-scleral contact lens wearer. CL Today e-newsletter; issued Jan. 20, 2013. Available at: http://www.clspectrum.com/newsletter/cltoday/january-20,-2013.aspx

    35. Walker M, Caroline P, Kinoshita B, et al. The protective advantage of scleral contact lenses. Presented during the 2015 Global Specialty Lens Symposium in Las Vegas.

Managing Ocular Surface Disease With Scleral Lenses
By Muriel Schornack, OD

    1. Schein OD, Rosenthal P, Ducharme C. A gas-permeable scleral contact lens for visual rehabilitation. Am J Ophthalmol. 1990;109(3):318-322.

    2. Foss AJ, Trodd TC, Dart JK. Current indications for scleral contact lenses. CLAO J. 1994;20(2):115-118.

    3. Tan DT, Pullum KW, Buckley RJ. Medical applications of scleral contact lenses: 1. A retrospective analysis of 343 cases. Cornea. 1995;14(2):121-129.

    4. Pullum KW, Buckley RJ. A study of 530 patients referred for rigid gas permeable scleral contact lens assessment. Cornea. 1997;16(6):612-622.

    5. Segal O, Barkana Y, Hourovitz D, et al. Scleral contact lenses may help where other modalities fail. Cornea. 2003;22(4):308-310.

    6. Rosenthal P, Croteau A. Fluid-ventilated, gas-permeable scleral contact lens is an effective option for managing severe ocular surface disease and many corneal disorders that would otherwise require penetrating keratoplasty. Eye Contact Lens. 2005;31(3):130-134.

    7. Visser ES, Visser R, van Lier HJ, Otten HM. Modern scleral lenses part I: clinical features. Eye Contact Lens. 2007;33(1):13-20.

    8. Klein M. Contact lens in cases of neuroparalytic keratitis. Br J Ophthalmol. 1943;27(5):221-222.

    9. Gould HL. Treatment of neurotrophic keratitis with scleral contact lenses. Eye Ear Nose Throat Mon. 1967;46(11):1406-1414.

    10. Gould HL. Management of the dry eye using scleral lenses (a report on 66 cases). Eye Ear Nose Throat Mon.1970;49(3):133-140.

    11. Constable JD, Carroll JM. The emergency treatment of the exposed cornea in thermal burns. Plast Reconstr Surg. 1970;46(3):309-312.

    12. Kok JH, Visser R. Treatment of ocular surface disorders and dry eyes with high gas-permeable scleral lenses. Cornea. 1992;11(6):518-522.

    13. Rosenthal P, Cotter JM, Baum J. Treatment of persistent corneal epithelial defect with extended wear of a fluid-ventilated gas-permeable scleral contact lens. Am J Ophthalmol. 2000;130(1):33-41.

    14. Tappin MJ, Pullum KW, Buckley RJ. Scleral contact lenses for overnight wear in the management of ocular surface disorders. Eye (London). 2001;15(Pt 2):168-172.

    15. Rosenthal P, Cotter J. The Boston Scleral Lens in the management of severe ocular surface disease. Ophthalmol Clin North Am. 2003;16(1):89-93.

    16. Pullum K, Buckley R. Therapeutic and ocular surface indications for scleral contact lenses. Ocul Surf. 2007;5(1):40-48.

    17. Williams ZR, Aquavella JV. Management of exposure keratopathy associated with severe craniofacial trauma. J Cataract Refract Surg. 2007;33(9):1647-1650.

    18. Blackmore SJ. The use of contact lenses in the treatment of persistent epithelial defects. Cont Lens Anterior Eye. 2010;33(5):239-244.

    19. Schornack MM, Pyle J, Patel SV. Scleral lenses in the management of ocular surface disease. Ophthalmology. 2014;121(17):1398-1405.

    20. Bavinger JC, DeLoss K, Mian SI. Scleral lens use in dry eye syndrome. Curr Opin Ophthalmol. 2015;26(4):319-324.

    21. Carracedo G, Blanco MS, Martin-Gil A, Zicheng W, Alvarez JC, Pintor J. Short-term effect of scleral lens on the dry eye biomarkers in keratoconus. Optom Vis Sci. 2016;93(2):150-157.

    22. Weber S, de Souza RB, Gomes JA, Hofling-Lima AL. The use of the esclera scleral contact lens in the treatment of moderate to severe dry eye disease. Am J Ophthalmol. 2016;163:167-173.

    23. Anderson NG, Regillo C. Ocular manifestations of graft versus host disease. Curr Opin Ophthalmol. 2004;15(6):503-507.

    24. Kim SK. Ocular graft vs. host disease. Ocul Surf. 2005;3(4 Suppl):S177-179.

    25. Kim SK. Update on ocular graft versus host disease. Curr Opin Ophthalmol. 2006;17(4):344-348.

    26. Schornack MM, Baratz KH, Patel SV, Maguire LJ. Jupiter scleral lenses in the management of chronic graft versus host disease. Eye Contact Lens. 2008;34(6):302-305.

    27. Takahide K, Parker PM, Wu M, et al. Use of fluid-ventilated, gas-permeable scleral lens for management of severe keratoconjunctivitis sicca secondary to chronic graft-versus-host disease. Bio Blood Marrow Transplant. 2007;13(9):1016-1021.

    28. Theophanous C, Irvine JA, Parker P, Chiu GB. Use of prosthetic replacement of the ocular surface ecosystem scleral lenses in ocular chronic graft-versus-host disease patients. Biol Blood Marrow Transplant. 2015;21(12):2180-2184.

    29. Papakostas TD, Le HG, Chodosh J, Jacobs DS. Prosthetic replacement of the ocular surface ecosystem as treatment for ocular surface disease in patients with a history of Stevens-Johnson syndrome/toxic epidermal necrolysis. Ophthalmology. 2015;122(2):248-253.

    30. Espana EM, Shah S, Santhiago MR, Singh AD. Graft versus host disease: clinical evaluation, diagnosis and management. Graefes Arch Clin Exp Ophthalmol. 2013;251(5):1257-1266.

    31. Townley JR, Dana R, Jacobs DS. Keratoconjunctivitis sicca manifestations in ocular graft versus host disease: pathogenesis, presentation, prevention, and treatment. Semin Ophthalmol. 2011;26(4-5):251-260.

    32. Balasubramaniam SC, Raja H, Nau CB, Shen JF, Schornack MM. Ocular graft-versus-host disease: a review. Eye Contact Lens. 2015;41(5):256-261.

    33. Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol. 1993;129(1):92-96.

    34. Rzany B, Mockenhaupt M, Baur S, et al. Epidemiology of erythema exsudativum multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis in Germany (1990-1992): structure and results of a population-based registry. J Clin Epidemiol. 1996;49(7):769-773.

    35. Schopf E, Stuhmer A, Rzany B, Victor N, Zentgraf R, Kapp JF. Toxic epidermal necrolysis and Stevens-Johnson syndrome. An epidemiologic study from West Germany. Arch Dermatol. 1991;127(6):839-842.

    36. Van Zyl L, Carrara H, Lecuona K. Prevalence of chronic ocular complications in Stevens-Johnson syndrome and toxic epidermal necrolysis. Middle East Afr J Ophthalmol. 2014;21(4):332-335.

    37. Heur M, Bach D, Theophanous C, Chiu GB. Prosthetic replacement of the ocular surface ecosystem scleral lens therapy for patients with ocular symptoms of chronic Stevens-Johnson Syndrome. Am J Ophthalmol. 2014;158(1):49-54.

    38. Tougeron-Brousseau B, Delcampe A, Gueudry J, et al. Vision-related function after scleral lens fitting in ocular complications of Stevens-Johnson syndrome and toxic epidermal necrolysis. Am J Ophthalmol. 2009;148(6):852-859.

    39. Ciralsky JB, Sippel KC, Gregory DG. Current ophthalmologic treatment strategies for acute and chronic Stevens-Johnson syndrome and toxic epidermal necrolysis. Curr Opin Ophthalmol. 2013;24(4):321-328.

    40. Iyer G, Srinivasan B, Agarwal S, Kamala Muralidharan S, Arumugam S. Comprehensive approach to ocular consequences of Stevens Johnson Syndrome - the aftermath of a systemic condition. Graefes Arch Clin Exp Ophthalmol. 2014;252(3):457-467.

    41. Mantelli F, Nardella C, Tiberi E, Sacchetti M, Bruscolini A, Lambiase A. Congenital corneal anesthesia and neurotrophic keratitis: diagnosis and management. Biomed Res Int. E-pub Sept 16, 2015.

    42. Chahal JS, Heur M, Chiu GB. Prosthetic replacement of the ocular surface ecosystem scleral lens therapy for exposure keratopathy. Eye Contact Lens. E-pub ahead of print: May 11, 2016.

    43. Gire A, Kwok A, Marx DP. PROSE treatment for lagophthalmos and exposure keratopathy. Ophthalmic Plast Reconstr Surg. 2013;29(2):e38-40.

    44. Grey F, Carley F, Biswas S, Tromans C. Scleral contact lens management of bilateral exposure and neurotrophic keratopathy. Cont Lens Anterior Eye. 2012;35(6):288-291.

    45. Schornack MM. Poster 9: Management of neurotrophic keratopathy with a scleral rigid gas permeable contact lens. Optometry. 2007;78(6):273-274.

    46. Weyns M, Koppen C, Tassignon MJ. Scleral contact lenses as an alternative to tarsorrhaphy for the long-term management of combined exposure and neurotrophic keratopathy. Cornea. 2013;32(3):359-361.

    47. Ciralsky JB, Chapman KO, Rosenblatt MI, et al. Treatment of refractory persistent corneal epithelial defects: a standardized approach using continuous wear PROSE therapy. Ocul Immunol Inflamm. 2015;23(3):219-224.

    48. Kim C, Lelli GJ Jr. Current considerations in the management of facial nerve palsy. Curr Opin Ophthalmol. 2013;24(5):478-483.

    49. Akpek EK, Mathews P, Hahn S, et al. Ocular and systemic morbidity in a longitudinal cohort of Sjogren’s syndrome. Ophthalmology. 2015;122(1):56-61.

    50. Behrens A, Doyle JJ, Stern L, et al. Dysfunctional tear syndrome: a Delphi approach to treatment recommendations. Cornea. 2006;25(8):900-907.

    51. Management and therapy of dry eye disease: report of the Management and Therapy Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. 2007;5(2):163-178.

Scleral Lenses for Irregular Corneas
By Michael J. Lipson, OD

    1. Efron N, Pearson RM. Centenary celebration of Fick’s Eine Contactbrille. Arch Ophthalmol. 1988;106(10):1370-1377.

    2. Pearson RM. Kalt, keratoconus, and the contact lens. Optom Vis Sci. 1989;66(9):643-646.

    3. Pearson RM, Efron N. Hundredth anniversary of August Müller’s inaugural dissertation on contact lenses. Surv Ophthalmol. 1989;34(2):133-141.

    4. Woodward MA, Blachley TS, Stein JD. The association between sociodemographic factors, common systemic diseases, and keratoconus: an analysis of a nationwide heath care claims database. Ophthalmology. 2016;123(3):457-465.

    5. Romero-Jiménez M, Santodomingo-Rubido J, Wolffsohn JS. Keratoconus: a review. Cont Lens Anterior Eye. 2010;33(4):157-166.

    6. Report on refractive surgery in the US. Market Scope LLC, 2013.

    7. U.S. Food and Drug Administration. Products and Medical Procedures. Available at: www.fda.gov/medicaldevices/productsandmedicalprocedures/; accessed July 28, 2016.

    8. Schornack MM. Scleral lenses: a literature review. Eye Contact Lens 2015;41(1):3-11.

    9. Stason WB, Razavi M, Jacobs DS, et al. Clinical benefits of the Boston Ocular Surface Prosthesis. Am J Ophthalmol 2010;149(1):54-61.

    10. Blackmore SJ. The use of contact lenses in The treatment of persistent epithelial defects. Cont Lens Anterior Eye. 2010;33(5):239-244.

    11. Deloss KS, Fatteh NH, Hood CT. Prosthetic replacement of the ocular surface ecosystem (PROSE) scleral device compared to keratoplasty for the treatment of corneal ectasia. Am J Ophthalmol. 2014;158(5):974-982.

    12. van der Worp E. A Guide to Scleral Lens Fitting (2nd ed.) Forest Grove, OR: Pacific University College of Optometry; 2015. Available at: http://commons.pacificu.edu/mono/10/; accessed Sept. 22, 2016.

    13. Kauffman MJ, Gilmartin CA, Bennett ES, Bassi CJ. A comparison of the short-term settling of three scleral lens designs. Optom Vis Sci. 2014;91(12):1462-1466.

    14. Esen F, Toker E. Influence of apical clearance on mini-scleral lens settling, clinical performance, and corneal thickness changes. Eye Contact Lens. E-pub ahead of print: May 11, 2016.

    15. Sonsino J, Mathe DS. Central vault in dry eye patients successfully wearing scleral Lens. Optom Vis Sci. 2013;90(9):e248-e251.

    16. Walker MK, Bergmanson JP, Miller WL, Marsack JD, Johnson LA. Complications and fitting challenges associated with scleral contact lenses: a review. Cont Lens Anterior Eye. 2016;39(2):88-96.

    17. Kinoshita B, Morrison S, Caroline P, et al. What makes a successful scleral lens wearer? Presented during the 2016 Global Specialty Lens Symposium in Las Vegas.

    18. Morrison S, Ritzmann M, Caroline P, et al. Sagittal height and scleral toricity in 30 normal eyes measured by three techniques. Presented during the 2016 Global Specialty Lens Symposium in Las Vegas.

    19. Bergmanson JP, Walker MK, Johnson LA. Assessing scleral contact lens satisfaction in a keratoconus population. Optom Vis Sci. 2016;93(8):855-860.

    20. Bergmanson JP, Barnett M, Naroo SA. Scleral gas permeable lenses have come of age. Cont Lens Anterior Eye. 2016;39(4):247-248.

Scleral Lens Care & Handling
By Melissa Barnett, OD and Mindy Toabe, OD

    1. Pecego M, Barnett M, Mannis MJ, Durbin-Johnson B. Jupiter Scleral Lenses: the UC Davis Eye Center experience. Eye Contact Lens. 2012;38(3):179-182.

    2. Pullum KW, Whiting MA, Buckley RJ. Scleral contact lenses: the expanding role. Cornea. 2005;24(3):269-277.

Scleral Lenses 601: Advanced Applications
By Lynette K. Johns, OD

    1. Harris MG. Contact lens flexure and residual astigmatism on toric corneas. J Am Optom Assoc. 1970;41(3):247-248.

    2. Harris MG, Chu CS. The effect of contact lens thickness and corneal toricity on residual astigmatism and flexure. Am J Optom Arch Am Acad Optom. 1972;49(4):304-307.

    3. Corzine JC, Klein SA. Factors determining rigid contact lens flexure. Opt Vis Sci. 1997;74(8):639-645.

    4. Walker M, Morrison S, Caroline P, et al. Laboratory Analysis of Tear Film Reservoir Clouding. Presented during the 2014 Global Specialty Lens Symposium.

    5. Walker MK. Scleral lenses: Clearing the Fog. I-Site e-newsletter; October 2014. Available at: http://www.netherlens.com/october_2014; accessed Aug. 20, 2016.

    6. Hemmati R, Walker M, Bergmanson J. Scleral lens tear film reservoir analysis: protein and lipid concentrations in midday fogging. Presented during the 2016 Global Specialty Lens Symposium.

    7. Johns L. Scleral Lenses: Turbid Clouding. I-Site e-newsletter; November 2014. Available at: http://www.netherlens.com/november_2014; accessed Aug. 20, 2016.

    8. Cornea Donor Study Investigator Group, Lass JH, Gal RL, Dontchev M, et al. Donor age and corneal endothelial cell loss 5 years after successful corneal transplantation. Specular microscopy ancillary study results. Ophthalmology. 2008;115(4):627-632.

    9. Collaborative Corneal Transplantation Studies Research Group. Effectiveness of histocompatibility matching in high-risk corneal transplantation. Arch Ophthalmol. 1992;110(10):1392-1403.

    10. Johns L. Frustration or Fenestration? I-Site e-newsletter; July 2011. Available at: http://netherlens.com/july_2011; accessed Aug. 20, 2016.