Objective:

To investigate the relationship between scleral lens fitting characteristics and the occurrence of midday fogging in habitual scleral lens wearers, highlighting its clinical significance.

Key Findings:

• 58% of participants reported experiencing scleral lens fogging, indicating a common issue among wearers.
• No substantial differences in fitting characteristics were found between eyes with and without fogging, suggesting other factors may be at play.
• Front-surface nonwetting and diffuse haze were significantly more common in those experiencing fogging, pointing to specific ocular surface conditions.
• Midday fogging was not linked to specific lens designs or care products, emphasizing the need for further investigation into other contributing factors.

Interpretation:

The study suggests that front-surface nonwetting and diffuse haze are key factors associated with midday fogging in scleral lens wearers, indicating potential ocular surface inflammation that may require clinical attention.

Limitations:

• The study's sample size was relatively small (48 participants), which may limit the generalizability of the findings.
• The observational nature limits causal inferences, suggesting the need for controlled studies to establish direct relationships.

Conclusion:

Midday fogging in scleral lens wearers is associated with specific biomicroscopic findings, particularly front-surface nonwetting and diffuse haze, rather than lens design or care products, highlighting the importance of these factors in patient management.