Scleral Lenses and Dry Eye

Keratoconjunctivitis Sicca (Dry Eye Syndrome) associated with chronic inflammatory autoimmune disease

Scleral lens and Autoimmune disorders

Chronic inflammatory autoimmune disorders include conditions such as Sjögren’s syndrome, rheumatoid arthritis, and systemic lupus erythematosus. Sometimes referred to as connective tissue diseases, these conditions can be associated with severe ocular inflammation (e.g., scleritis, episcleritis, and peripheral ulcerative keratitis). Lacrimal gland function can be impaired in these patients. Decreased tear production causes classic dry eye symptoms such as burning, gritty sensation, ocular fatigue, blurred vision or photophobia. Severe cases may lead to non-infectious keratitis, corneal neovascularization, or corneal scarring.

Scleral lens to preserve the integritey of the ocular surfac

The goals of treatment are to minimize patient symptoms and preserve the integrity of the ocular surface; evidence-based guidelines on mangement of keratoconjunctivitis sicca have been published. Recommendations for therapeutic intervention become more aggressive as symtom severity or ocular surface compromise increases. Although scleral lenses are not generally considered first line therapy for keratoconjunctivitis associated with systemic inflammatory disease, success has been reported with scleral lens therapy in these patients.

source: Contact Lens spectrum, October 2016

A scleral lens, also known as a scleral contact lens and ocular surface prostheses is a large contact lens that rests on the sclera and creates a tear-filled vault over the cornea. Scleral lenses are designed to treat a variety of eye conditions, many of which do not respond to other forms of treatment.

Scleral Lenses and Dry Eye

Benefits of scleral lenses

Scleral lenses are uniquely suited to treat ocular surface disease. Unlike other types of contact lenses, scleral lenses don’t come in contact with potentially fragile or compromised epithelium. Instead, the post-lens fluid reservoir continuously bathes the cornea and promotes epithelial healing. Furthermore, the lens provides a barrier between the anterior surface of the eye and the posterior eyelid, and protects the corneal epithelium from shear forces generated by eyelid movement over the ocular surface during blinking. Scleral lens wear may even affect biomarkers that have been identified in patients with dry eye disease.