The idea of a scleral lens was first placed on paper by DaVinci in the early 16th century. The very first scleral lens was fabricated from glass (hand blown) in Europe in the 1880's. DaVinci's idea of correcting the eye optically with an enclosed liquid reservoir historically morphed into the highly oxygen permeable computer designed scleral lenses used today.
The benefits of today's lenses include not only providing excellent vision and comfort but also protecting the fragile ocular surface from exposure to and damage from the environment and the blinking action of the eyelids. Scleral lens comfort is rarely a problem and vision correction with highly oxygen permeable materials in a fluid filled reservoir is exceptional.
Scleral lenses are an amazing life changing technology for healing a sick eye and for providing healthy all day clear vision to patients suffering from many ocular diseases and conditions. Because these lenses vault over the cornea, they are an ideal option for irregular corneal conditions that diminish vision such as keratoconus, corneal dystrophies and degenerations, pellucid marginal degeneration, post-surgical complications, chronic dry eyes, and corneal scars. There are many patients who have lost quality vision as a result of refractive surgeries such as LASIK and Radial Keratotomy. Scleral lenses are the best option of restoring quality vision and ocular comfort to this patient population.
Because lenses vault over the cornea and do not touch the corneal surface when properly fit, these lenses can have a healing effect on compromised corneal tissues. This is because the cornea is always in a liquid environment. Because of this liquid environment created by lenses, protection and healing of the ocular surface can take place. Because of their stability, comfort and all day wear capacity, patients with keratoconus and other corneal conditions and diseases can enjoy clear vision once again considering that these patients can not obtain functional vision with eyeglasses or conventional contact lenses once their lenses are removed.
In my opinion, scleral lenses are an amazing life changing technology. I have seen hundreds of patients severely depressed about their vision disabilities who have been able to achieve clear (20/20) comfortable vision once again. Many of these patients have told me they have had thoughts of suicide due to their loss of vision. All of these patients are functioning on a very high level visually once again thanks to modern scleral lens technology.
This is a profile view of an eye that underwent LASIK surgery 15 years ago. For 7 years this patient saw clearly. In a matter of one month, this patient's vision with this eye dramatized dramatically to the point where glasses or conventional contact lenses were not able to provide a functional vision to this patient with this eye. The condition seen in this photo is called “Corneal Ectasia”. LASIK is a surgical procedure that thins out the cornea. In other words, the corneal “wall” is weakened. Over a period of years, the pressures inside the eye against this weakened corneal “wall” can make it protrude or “buckle”. When this takes place we call this “post LASIK corneal ectasia”.
Corneal Ectasia has been known to take place up to 12 years after the LASIK surgery was done. There is no way to determine with 100% certyty if corneal ectasia will take place in any patient who undergoes LASIK surgery. While corneal ectasia is not a common seen complication of LASIK surgery, it is not uncommon either. In this photo note the protrusion of the lower half of this cornea. This is the cornea bulging forward or the ectasia.