Contact Lens, Scleral, Gas Impermeable, per Lens

Name of the Procedure:

• Common Names: Scleral contact lens, gas-permeable lens
• Technical/Medical Terms: V2530, scleral gas impermeable contact lens

Summary

Scleral contact lenses are specialized lenses that rest on the sclera (the white part of the eye) and create a tear-filled vault over the cornea. They are used to address several complex eye conditions and provide significant relief and improved vision for patients.

Purpose

Scleral contact lenses are primarily used to manage and treat ocular surface diseases and conditions like keratoconus, severe dry eye syndrome, and post-surgical corneal irregularities. The main goals are to improve vision, reduce discomfort, and protect the corneal surface.

Indications

• Patients with keratoconus or other corneal irregularities
• Severe dry eye syndrome unresponsive to other treatments
• Post-corneal surgery complications
• Ocular surface disease

Preparation

• Comprehensive eye exam and contact lens fitting
• No specific fasting or medication adjustments required
• May involve diagnostic tests like corneal topography or optical coherence tomography (OCT)

Procedure Description

1. Fitting and Measurement:

   • An eye care professional measures the eyes' surface curvature.
   • Specialized equipment like corneal topographers are used.

2. Lens Trial and Evaluation:

   • Trial lenses are placed on the eye.
   • The fit and comfort are assessed through various tests.

3. Customization:

   • The lenses are customized based on detailed measurements and patient comfort.
   • Follow-up visits are scheduled to fine-tune the fit.

Tools Used:

• Corneal topographer
• Slit lamp
• Trial scleral lenses

Duration

The entire fitting process can take several visits over a period of weeks to months. Each fitting session may last from 30 minutes to an hour.

Setting

• Outpatient clinic
• Optometrist or ophthalmologist’s office

Personnel

• Optometrists
• Ophthalmologists
• Ophthalmic technicians

Risks and Complications

• Initial discomfort or irritation
• Difficulty in insertion and removal
• Risk of lens contamination or infection if not cleaned properly
• Potential for corneal edema if not fit correctly
• Rarely, allergic reactions to lens materials

Benefits

• Improved vision quality
• Enhanced comfort for patients with severe dry eyes
• Protection of the corneal surface
• Stability during blinking and eye movements

Recovery

• No downtime required; normal activities can typically be resumed immediately after each fitting session.
• Ongoing adjustments and follow-up appointments to ensure optimal fit and comfort.
• Patients must adhere to a strict cleaning and care regimen for the lenses.

Alternatives

• Other types of contact lenses (e.g., soft or rigid gas-permeable lenses)
• Surgical options like corneal transplantation
• Glasses designed for specific conditions
• Pros and cons: Scleral lenses often provide better comfort and visual acuity for complex corneal issues compared to other lenses or glasses.

Patient Experience

Patients might initially experience some discomfort as they get used to inserting and wearing the lenses. Over time, most patients find them comfortable and greatly beneficial. Pain management is typically not required, but lubricating eye drops may be recommended for added comfort. Regular follow-up appointments will ensure that the lenses continue to fit well and provide maximum benefit.