Scleral Lens Issues and Complications Related to Handling, Care and Compliance

Abstract

Scleral contact lens (ScCL) handling may be challenging and is the principle reason for ScCL drop out. ScCL care systems are more intricate than other lens modalities and include solutions for cleaning, disinfection, storing, rinsing and filling the lens; respecting the use of each solution recommended is fundamental. Replacement of the lenses, solutions, case and plungers are important in order to decrease the risk of adverse events associated with ScCL wear. Compliance is crucial regarding hygiene, solution use, case and plunger care, wear time, follow-up schedule, and handling techniques. Non-compliance may lead to discontinuation of ScCL due to difficulties associated with this unique lens design.
 This paper presents complications secondary to handling, care and compliance that clinicians and patients may encounter while wearing ScCL. Instructions are provided to enhance the understanding on management surrounding these issues. This manuscript includes three tables to summarize types of complications, their symptoms, clinical signs, etiology, and management for a quick find index for easy consultation during daily clinical practice.

BCLA CLEAR - Scleral lenses

“…Poor wettability typically presents as a greasy anterior lens surface and is associated with discomfort, reduced wearing time, and disturbed vision [212]. Patients with ocular surface disease (e.g.…”

Nonpolar Lipids Contribute to Midday Fogging During Scleral Lens Wear

“… 26 , 27 However, this distinctive system of contact lens wear can present with complications such as infection and tissue changes, 28 – 31 as well as complications within the FR. 28 , 29 , 32 – 36 The FR is formed by the mixing of the application solution (e.g., sterile saline), used to fill the concave portion of the SL, with the tears. There is an overall lack of understanding in the eyecare community with regards to the FR, which bears little resemblance to a normal tear film and is instead a deep reservoir, ranging from 100 to 1000 µm in depth over different areas of the cornea in successful SL wearers.…”