Benefits
Sclerals have
retained a unique role in contact lens practice, but clinical practice
techniques feature only minimally in the current training programme for optometrists
and ophthalmologists. As a consequence, there is poor recognition of the occasions
when sclerals are indicated, and difficulty finding suitably experienced practitioners.
Traditional methods are perceived to be cumbersome, but the introduction of RGP
materials has reduced sequelae, and has enabled simple and predictable fitting process.
The application of sclerals can now be considered as a feasible option for a range
of visual and therapeutic conditions, and for lower grades of pathology, rather
than only at a stage which would be described as end point pathology.
Keratoconus
Downwardly displaced and protrusive ectasia. A scleral lens is seen in situ with
a glancing apical contact.
Corneal transplant
25.00DC post-op astigmatism with a ridge in the inferior sector. A non-ventilated
RGP scleral lens gave a VA of 6/9 with all day wear.
There is a substantial role for sclerals in keratoconus mangement, which in recent
years has accounted for just over 50% of the total requirement for sclerals.
Given reasonable contact lens visual potential, RGP sclerals offer a valuable alternative
to corneal transplantation.
There are also many applications following corneal transplantation.
High myopes or aphakes may find sclerals the lens of choice, and the retention of
a pre-corneal fluid reservoir offers unique therapeutic potential for some dry eye
conditions.
We estimate that there are at least 3,000 patients using our RGP lenses for a variety
of corneal conditions, and many report their quality of life has been significantly
improved.