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Barnett M, Courey C, Fadel D, Lee K, Michaud L, Montani G, van der Worp E, Vincent SJ, Walker M, Bilkhu P, Morgan PB. CLEAR - Scleral lenses. Cont Lens Anterior Eye 2021; 44:270-288. [PMID: 33775380 DOI: 10.1016/j.clae.2021.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
Abstract
Scleral lenses were the first type of contact lens, developed in the late nineteenth century to restore vision and protect the ocular surface. With the advent of rigid corneal lenses in the middle of the twentieth century and soft lenses in the 1970's, the use of scleral lenses diminished; in recent times there has been a resurgence in their use driven by advances in manufacturing and ocular imaging technology. Scleral lenses are often the only viable form of contact lens wear across a range of clinical indications and can potentially delay the need for corneal surgery. This report provides a brief historical review of scleral lenses and a detailed account of contemporary scleral lens practice including common indications and recommended terminology. Recent research on ocular surface shape is presented, in addition to a comprehensive account of modern scleral lens fitting and on-eye evaluation. A range of optical and physiological challenges associated with scleral lenses are presented, including options for the clinical management of a range of ocular conditions. Future applications which take advantage of the stability of scleral lenses are also discussed. In summary, this report presents evidence-based recommendations to optimise patient outcomes in modern scleral lens practice.
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Affiliation(s)
- Melissa Barnett
- University of California, Davis Eye Center, Sacramento, CA, United States.
| | | | | | - Karen Lee
- University of Houston, College of Optometry, Houston, TX, United States
| | | | - Giancarlo Montani
- Università del Salento, Dipartimento di Matematica e Fisica CERCA, Lecce, Italy
| | - Eef van der Worp
- Eye-Contact-Lens Research & Education, Amsterdam, NL, Netherlands
| | - Stephen J Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Contact Lens and Visual Optics Laboratory, Brisbane, Australia
| | - Maria Walker
- University of Houston, College of Optometry, Houston, TX, United States
| | - Paramdeep Bilkhu
- School of Optometry & Vision Science, Aston University, Birmingham, United Kingdom
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
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