C
ORNEA
44 | EYEWORLD | JULY 2019
Contact
information
Kramer:
elise@miamicontactlens.com
Jacobs:
deborah_jacobs@meei.harvard.edu
Thakrar: thakrarv@gmail.com
Trattler: wtrattler@gmail.com
DEVICE FOCUS
by Rich Daly
EyeWorld Contributing Writer
Jacobs, MD. Other scleral lens candidates are
patients with ocular surface disease that inter-
feres with comfort or vision, as well as patients
with regular astigmatism who are unhappy with
quality of vision in spectacles and soft lenses
and have occupational or recreational demands
that can't be met by corneal RGP lenses.
"That would be people who work in windy
or dusty environments and athletes," Dr. Jacobs
said. "Baseball players meet both criteria. Out-
door workers of all sorts are candidates."
Dr. Jacobs refers patients for a scleral lens
trial or consultation before deciding whether to
proceed with a fitting. The trial should address
whether the patient's vision improves or the
lens provides support for the ocular surface,
and the patient's ability to manage the applica-
tion, removal, and lens care regimen should be
considered.
S
cleral lenses can offer a range of
benefits to several types of patients,
but they also carry the potential for
complications.
The primary indication for scleral
lens referral is the correction of vision
for irregular astigmatism and corneal
ectasias, said Vishakha Thakrar, OD.
"The saline between the posterior lens and
anterior cornea creates a tear lens to correct
vision in irregular corneas," Dr. Thakrar said.
"Commonly treated conditions include kerato-
conus, pellucid marginal degeneration, post-
LASIK ectasia, radial keratotomy, penetrating
keratoplasties, and corneal scars, dystrophies,
and degenerations."
Good candidates for scleral lenses include
those with irregular astigmatism that cannot be
corrected with spectacles, soft lenses, or corneal
rigid gas permeable lenses, said Deborah S.
Re-examining scleral lenses
About the doctors
Vishakha Thakrar, OD
Private practice
Vaughan, Ontario
Deborah S. Jacobs, MD
Associate professor of
ophthalmology
Harvard Medical School
Boston
William Trattler, MD
Center for Excellence
in Eye Care
Miami
Elise Kramer, OD
Private practice
Miami
continued on page 46
Corneal staining pattern after short-term use of a scleral
lens
Limbal staining pattern after short-term use of a scleral
lens
Source (all): Vishakha Thakrar, OD
