As I write this, I am still energized from the recent Contact Lenses of the Americas Specialists Symposium (CLASS) in Bogotá, Columbia. More than 1,000 attendees from North to South America (and beyond) attended this inaugural two-day event. This congress sponsored by Contamac covered all aspects of specialty contact lenses, including specialty soft, orthokeratology and scleral lenses. Key opinion leaders from all over the world gave forty minute lectures in both English and Spanish with simultaneous translation. In addition, small workshops were provided by various sponsors.
Eight years ago, Nathan Efron pronounced that the 1998 prediction that rigid contact lenses would be obsolete by the year 2010 has essentially turned out to be correct.1 He continued that rigid lenses are being fitted by a minority of practitioners with specialist skills/training. “Certainly, rigid lenses can no longer be considered as a mainstream form of contact lens correction.” It was with great surprise in 2018, at the Nederlands Contactlens Congress (NCC), Nathan Efron stated that he was wrong. Fortunately, rigid lenses still persist.
It is encouraging that rigid contact lens prescribing comprise 10% of all contact lens fits2 based on data obtained from mail or electronic survey forms from 20,000 fits across 30 markets. With the additional of orthokeratology, rigid contact lens prescribing accounts to 11% of all fits.2
With this growing modality, it has been called the “the rigid lens renaissance: a surge in sclerals",3 "scleral lenses are blooming”4 and "scleral gas permeable lenses have come of age".5 In addition, the number of publications in the peer reviewed literature is increasing rapidly.6
The popularity of scleral lenses is immense and continues to grow. As demonstrated by CLASS, the passion and interest in specialty lens education is contagious. However, there are still many unknowns about this modality and long term peer reviewed research is still needed. Future research will provide best practices for patients, practitioners and the industry.
1. Efron N. Obituary--rigid contact lenses. Cont Lens Anterior Eye. 2010 Oct;33(5):245-52. doi: 10.1016/j.clae.2010.06.009. Epub 2010 Jul 31.
2. Morgan, PB, Woods CA, Tranoudis, IG, et al. International Contact Lens Prescribing in 2017. Contact Lens Spectrum 33 January 2018 28-33.
3. S.J. Vincent. The rigid lens renaissance: A surge in sclerals. Contact Lens & Ant Eye; 41 (2018), 139-143.
4. E. van der Worp. Scleral lenses (are) special. Contact Lens and Anterior Eye, 40 (2017), 271-2.
5. J.P.G. Bergmanson, M. Barnett, S.A. Naroo. Scleral gas permeable lenses have come of age. Contact Lens & Anterior Eye; 39 (2016), 247–8.
6. E. van der Worp, D. Bornman, D.L. Ferreira, M. Faria-Ribeiro, N. Garcia-Porta, J.M. González-Meijome, Modern scleral contact lenses: A review. Contact Lens & Anterior Eye. 37 (2014) 240-50.
Dr. Barnett is a principal optometrist at the University of California Davis Eye Center in Sacramento, specializing in anterior segment disease and specialty contact lenses. She is the past president of the Scleral Lens Education Society. She is an advisor to and/or has received honoraria or travel expenses from AccuLens, Alcon, Alden Optical, Allergan, Bausch + Lomb, Contamac, CooperVision, EveryDay Contacts, Johnson & Johnson Vision, Ocusoft, Paragon Bioteck, RaayonNova, ScienceBased Health, Shire, SynergEyes, and Visioneering Technologies.