Post‐lens tear turbidity and visual quality after scleral lens wear

Abstract

The VA decrease during the scleral lens wearing, filled with preserved saline solution, was due to the increasing post-lens tear layer turbidity.

Evaluation of tear meniscus by optical coherence tomography after different sodium hyaluronate eyedrops instillation

“…The relationship between the number of particles and the total area of the tear meniscus postartificial tear (Number of particles/mm 2 ) was analysed in accordance with the protocol described by Carracedo et al. (; Fig. ).…”

The temporal dynamics of miniscleral contact lenses: Central corneal clearance and centration

“…While it is well known that scleral contact lenses gradually "settle back" posteriorly towards the cornea due to compression of the tissues underlying the landing zone [2], there is no consensus on the optimal initial corneal clearance (i.e. the thickness of the post-lens tear layer following lens insertion) to avoid central or limbal corneal touch, to minimise potential corneal hypoxia [3][4][5], or reduce post-lens tear layer debris or turbidity [6]. The recommended initial corneal clearance varies considerably with manufacturer or practitioner fitting philosophy, the lens type (fenestrated or non-fenestrated) and the ocular condition (ocular surface disease or corneal ectasia).…”

Optical coherence tomography and scleral contact lenses: clinical and research applications

“…OCT imaging has shed light on midday fogging, which is an accumulation of debris or particulate matter (potentially conjunctival lipid or mucin) within the post‐lens tear layer, typically observed in ~20–30 per cent of scleral lens wearers (Figure ). Since midday fogging can reduce contrast sensitivity and visual acuity by one to two lines, and can accumulate rapidly following lens insertion, affected patients are often required to remove, rinse, refill and reinsert their scleral contact lenses a number of times throughout the day.…”

“…Some clinicians suggest that minimising corneal clearance and altering the haptic alignment can reduce midday fogging; however, Carracedo et al observed no relationship between initial central corneal vault and post‐lens tear layer turbidity (particles/mm 2 , derived from OCT image analysis). Clinically, OCT also plays an important role in differentiating a reduction in visual acuity during scleral lens wear due to either midday fogging, corneal oedema or some other aetiology.…”