Basics of Scleral Lenses and First Lens Selection | OOLS |

Dr. Daddi Fadel, a practicing optometrist, and a contact lens expert begins by defining the scleral lens, stating its advantages and contraindications. She dives straight into explaining the three-step scleral lens fitting process.

1. Patient selection (07:58)

a. No age limit (09:44)

b. Anomalies of corneal endothelium (10:08)

c. Diabetic or immunocompromised patients (11:25)

d. Glaucoma (11:40)

e. Sports contraindications (13:25)

f. Ocular Examination (14:06)

2. Trial lens selection (17:18)

a. Diameter (18:05)

b. Lens sagittal height (22:50)

3. Observation (24:50)

a. Center corneal clearance (26:34)

b. Peripheral corneal clearance (27:22)

c. Limbal clearance (27:54)

d. Blanching vs indentation (28:58)

e. Scleral toricity (32:24)

f. Edge fitting (41:30)


Dr. Fadel shows us the different patterns that we may see on fitting spherical scleral lenses on a toric sclera. We also discuss ordering the lens and the schedule for re-assessment of the lens fit. Lastly, we learn some tips and tricks for fitting scleral lenses

1. Air Bubbles (45:04)

2. Lens application techniques and devices (46:25)

3. Lens removal techniques and devices (53:32)

4. Debris or Midday fogging (55:44)

5. Poor wettability (56:05)

6. Light and observation when assessing the lens (59:30)

7. Empathetic Communication (58:55)


We conclude the session with some resources available for the audience. The session ends with a Q and A section for the live audience.


References

Papers

Fadel D, Kramer E. Potential contraindications to scleral lens wear. Cont Lens Anterior Eye. 2019 Feb;42(1):92-103.

https://pubmed.ncbi.nlm.nih.gov/30392894/


Picot C, Gauthier AS, Campolmi N, Delbosc B. Qualité de vie des patients équipés en verres scléraux [Quality of life in patients wearing scleral lenses]. J Fr Ophtalmol. 2015 Sep;38(7):615-9.

https://pubmed.ncbi.nlm.nih.gov/26001955/


Koppen C, Kreps EO, Anthonissen L, Van Hoey M, Dhubhghaill SN, Vermeulen L. Scleral Lenses Reduce the Need for Corneal Transplants in Severe Keratoconus. Am J Ophthalmol. 2018 Jan;185:43-47.

https://pubmed.ncbi.nlm.nih.gov/29103959/


Kornberg DL, Dou E, Wang Y, St Clair R, Lee MN, Sood P, Fernandez AA, Ciralsky JB, Sippel KC, Rosenblatt MI. Clinical Experience With PROSE Fitting: Significance of Diagnosis and Age. Eye Contact Lens. 2016 Mar;42(2):124-8.

https://pubmed.ncbi.nlm.nih.gov/26020485/


O'Donnell C, Efron N. Corneal endothelial cell morphometry and corneal thickness in diabetic contact lens wearers. Optom Vis Sci. 2004 Nov;81(11):858-62.

https://pubmed.ncbi.nlm.nih.gov/15545812/


Editorials

Contact Lens Spectrum – Scleral lenses: Prepare for landing. Fadel, D.

https://www.clspectrum.com/issues/2017/august-2017/scleral-lenses-prepare-for-landing


Watch the complete session below:


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Integrated Philippine Association of Optometrist (IPAO)

Philippine Society of Public Health and Occupational Optometry (PSPHOO)

Optometry Vietnam

Education Supported by:

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