No abstract

Jupiter scleral lenses provide acceptable visual acuity and comfort in patients with keratoconus. The availability of diagnostic lenses facilitates the fitting process.

Eye care providers of all ages are fitting scleral lenses. The number of individuals who fit this lens modality has increased during the past decade. Scleral lenses are being fit by providers in a wide range of practice settings. Most scleral lenses are prescribed for corneal irregularity.

Scleral lenses rank second only to corneal rigid gas-permeable lenses for management of corneal irregularity. Scleral lenses are generally considered after other medical intervention and before surgery for the management of ocular surface disease.

Objectives Compression of episcleral veins or deformation of tissue in the Schlemm canal beneath the landing zone of scleral lenses could elevate intraocular pressure (IOP). We examined the effect of 2 hours of small-diameter scleral lens wear on IOP. Methods Twenty-nine participants, 29 ± 6 years old (mean ± SD) who had no history of eye disease or scleral lens wear were included in the study. Each participant was fitted with a 15-mm Jupiter scleral lens on 1 eye (study eye). IOP was measured in both eyes by pneumatonometry centrally on the cornea and peripherally on the sclera. The lens was then placed on 1 eye and was worn for 2 hours. IOP was remeasured immediately after lens placement, at 1 and 2 hours of lens wear, and immediately after lens removal. IOP after removal of the scleral lens was compared to IOP before placing the lens and to IOP in the control eye by using paired t-tests. Results Immediately after removing the scleral lens, mean central IOP in the study eye (13.9 ± 3.1 mm Hg) was not different from mean central IOP in the control eye (13.5 ± 2.2 mm Hg, P=.4) or in the same eye before lens wear (13.6 ± 1.9 mm Hg, P=.6). There were also no differences in IOP measured peripherally at 2 hours of lens wear (P=.8). Conclusions Neophyte scleral lens wear of a 15-mm scleral lens for 2 hours does not increase IOP in healthy eyes.

Agreement between all refractive assessments was comparable to previously reported agreement between repeated measures of SR. Agreement between AR and SR was slightly stronger than between OPD and SR. Although both the OPD and AR results, in general, showed a high level of agreement with SR, results beyond ±0.50D (5.8% for AR, 10% for OPD) would discourage prescribing spectacles directly from either instrument.

Indications for scleral lens wear are well-established. Developing areas of research on the physiologic impact of scleral lens wear on the ocular surface, the use of technology to improve scleral lens vision and fit, and the impact of these devices on the quality of life should further enhance our understanding of scleral lenses in the future.

Jupiter scleral lenses can relieve symptoms of KCS and may improve vision in patients with cGVHD.