A Guide to Identifying
Potential Scleral Lens Patients
Sept 20, 2014
Natalie Santelli, MAT, OD

• An introduction to scleral lenses
• Goals of
Treatment
• Indications for
Treatment
• Presenting Scleral
Lenses to Patients

1508
• Leonardo daVinci
1888
• Adolf Fick Blown Glass “Vessicle”
1888
• Eugene Kalt Glass CTL with KCN
1889
• August Mueller Glass CTL high myopia
1900
’s
• PMMA Scleral Lenses & impression molding
• Gas Permeable Scleral Lenses
1970’s

Names
Alternative
Names
Diameter Bearing
Corneal
Corneo-Scleral
Corneal-
Limbal
Semi-Scleral
Limbal
8.0 to 12.5 mm All on cornea
12.5 to 15.0 mm
Shared b/t the cornea and sclera
Tear Reservoir none
Limited capacity
(Full) Scleral Haptic
15 to 25 mm
Mini vs Large
(>18 mm)
Scleral
All on Sclera
Somewhat limited to unlimited tear reservoir capacity

• Reduce symptoms and support healing by restoring a healthy ocular surface environment
• Improve blurry vision by masking surface corneal irregularities and transmitting a sharper image to the retina
• Prevent damage by protecting the cornea against the environment and eyelids

Indications for Scleral Lens Treatment
• Vision Improvement
– Correcting the irregular cornea: Keratoconus, ectasia, post-LASIK, corneal trauma/infections, post corneal transplants (PKP), high myopia/hyperopia
• Corneal Protection
– Exposure keratitis/ocular surface disease patients
– Sjögren’s Syndrome
– Persistent Epithelial Corneal Defects
– Steven’s Johnson Syndrome
– Graft Versus Host Disease (GVHD)
– Ocular Cicatricial Pemphigoid
– Neurotrophic Corneal Disease
– Atopic Keratoconjunctivitis
• Pharmaceutical Delivery
– Antibiotic coverage while a persistant epithelial defect heals
– Reduce corneal neovascularization with anti-VEGF medications
– Pain mediation with low levels of sodium channel modulators

• Theses next slides will expand upon the indications for scleral lenses as mentioned in the previous slide