Although scleral lenses are made from the same materials as rigid gas permeable (GP or RGP) lenses, they fit the eye very differently than smaller lenses. Scleral lenses land on the clear tissue that covers the sclera (the white part of the eye) and maintain a fluid reservoir over the cornea (the dome of clear tissue that covers the iris – the colored part of the eye). These differences in the way that scleral lenses interact with the eye’s surface may lead to a different set of complications compared to problems seen with GP lenses. As scleral lenses become more commonly used in the treatment of keratoconus, we need to learn more about complications that can be caused by scleral lenses.
The SCOPE (Scleral lenses in Current Ophthalmic Practice: an Evaluation) study group surveyed eye care providers from all over the world about complications they had encountered with their patients wearing scleral lenses. 989 eyecare professionals participated in the survey, treating nearly 85,000 patients who had been fitted with scleral lenses. The survey was administered by the Mayo Clinic Survey Research Center.
The most commonly reported complications (462 patients) were caused by applying or removing scleral lenses incorrectly. An additional 148 patients developed an eye problem because they used eyecare products that were not recommended by their doctors. (For example, using contact lens cleaner instead of conditioning solution to store lenses, or saliva to clean lenses.)
Corneal edema or swelling was reported in 385 patients, and new blood vessel growth into the cornea was reported in 238 patients. 70 patients experienced corneal infections while wearing scleral lenses. Two patients experienced graft rejection while wearing scleral lenses.
These findings are encouraging: complications due to scleral lens wear appear to be relatively rare. Nevertheless, patients who wear scleral lenses should following their eyecare professional’s recommendations for lens care products and their advice for applying and removing their lenses. KC patients should be especially vigilant, and should see their eye doctor promptly if they develop eye pain, redness, reduced vision, or if something just “doesn’t feel right”.
Thank you to the SCOPE study participants for sharing their observations and patient outcomes. To learn more about the researchers who led this study, visit:
- Muriel Schornack, OD / Mayo Clinic, Rochester, MN.
- Amy Nau, OD / Korb and Associates, Boston, MA
- Ellen Shorter, OD, FAAO / Illinois Eye & Ear Infirmary, Chicago, IL
- Jennifer Harthan, OD, FAAO / Illinois College of Optometry, Chicago, IL
- Joseph Barr, OD, FAAO / Ohio State University, Columbus, OH
- Cherie Nau, OD / Mayo Clinic, Rochester, MN