Scleral Lens Education Society

Scleral Lens Education Society Officers at the annual Executive Board meeting at Global Specialty Lens Symposium! A fantastic opportunity to collaborate, plan, and continue our mission to promote excellence in scleral lens education worldwide. #ScleralLenses #GSLS2025 #SLS

Stop by and say hi to the SLS at the exhibit hall! #GSLS2025

IFSLR 2025 has kicked off! Led by Public Education Chair Kelsea Skidmore, alongside Gloria Chiu, OD, FAAO, FSLS and Robert Ensley, the Scleral Lens Education Society presented A Case Based Walkthrough of the Scleral Fitting Process. Looking forward to a great conference! 💫 #GSLS2025

“Here is an interesting case where we used a small hole in a scleral lens to create an area of increased oxygen permeability close to the cornea. This patient has an older corneal transplant (done because they have keratoconus). With our initial molded scleral lens, vision and comfort were great but because the cornea is so delicate, the corneal transplant started having a mild rejection. This rejection with lens wear is rare but can occur due to the reduction in oxygen to the eye with lens wear. Because we get better vision in a scleral lens than anything the patient has tried before (RPs, hybrids), we put a fenestration in the haptic zone of the lens, almost right above the area of stem cells. Putting in these fenestrations (holes) in this area does not induce a bubble like putting them in the optic zone (further in), but can help in increasing oxygen. Of course with oxygen, we do everything we can BEFORE putting fenestrations in. This includes thinning the lens plastic as much as possible, putting lens as close to the eye as possible to minimize the tear film thickness, and using a highly oxygen permeable material. Our patients’ conditions are usually very complicated so it is our honor to join them on their journey to achieve the best vision possible and keep the eye healthy.” By Caitlin Morrison, OD, FAAO, FSLS (@eyesplain)

“The power of options! A little sampling of the various types of specialty and scleral lenses used in clinic this week. Having access to different specialty lens options is a game changer for custom-fitting each patient’s unique eye needs.” By Stephanie Pisano, OD, FAAO, FSLS (@drstephpisano)

LensBase was developed by a keratoconus patient to be the cleanest, most comfortable, and most portable scleral insertion device on the market. At a retail price of $34.95, it’s accessible to anyone. Follow @thelensbase or visit www.thelensbase.com for more info. Email info@thelensbase.com for wholesale inquiries.

“If your scleral lens feels blurry or uncomfortable *immediately* upon insertion, there is most likely an air bubble underneath the lens. 🫧 You can check for bubbles right after insertion by checking your vision (clear vision = likely no bubble, blurry vision=bubble), or by using the light on the back of your cell phone to shine on your eye and check for the appearance of a bubble in the mirror. If you have a bubble immediately upon insertion, simply remove, rinse, and re-insert the lens: 1. Remove the lens with the small plunger 2. Rinse the lens with saline 3. Fill the lens *all the way up* with the saline (using too little saline can cause the bubbles). The lens should be almost overflowing; you’ll see that the saline has a little rounded cap at the top of the lens. 4. Re-insert the lens. Don’t worry if you need to repeat this process a few times, especially if you are new to inserting and removing scleral lenses. Practice makes perfect, and within a few weeks, patients usually get the hang of inserting lenses with minimal bubbles! Image: Scleral lens with air bubble underneath lens via @bauschlomb.” By Caitlin Morrison, OD, FAAO, FSLS (@eyesplain)

“It’s incredibly rewarding to share this story: a young man who, due to keratoconus, had previously undergone a corneal transplant, is now able to see 20/20 thanks to scleral lenses—a remarkable result, considering his vision was below 20/200. Scleral lenses fit perfectly on the scleral surface without touching the cornea, creating a tear layer that protects the eye while providing clear and comfortable vision. In cases like this, scleral lenses not only deliver exceptional vision but also enhance visual comfort and overall eye health. It’s amazing to restore such a significant level of vision and quality of life to someone who thought they had lost it forever.” By Charles Di Benedetto (@dr.charlesdibenedetto)

“Here is a case of a patient who suffered a traumatic ocular injury that resulted in significant corneal scarring This patient’s vision was severely compromised. Best corrected vision was 20/320. They were referred to our office for Scleral Lenses to see if vision could be improved to avoid a corneal transplant. After designing a custom Scleral Lens, this patient is now able to see 20/30 and avoid surgery. You can see the opacification from the scarring even under the Scleral Lens in the bottom image in optic section This patient’s ocular surface is also very dry, and the Scleral Lens will aid in providing a lubricated environment for the cornea under the lens” By Anith Pillai (@anithp23)

“Should You Deep Clean Your Scleral Lenses? When we wear contact lenses, some substances in our tear film such as proteins, glycoproteins, and lipids accumulate on the contact lens surface. This creates an environment for microorganisms like bacteria to adhere to the surface. Contact lenses and contact lens cases can both accumulate biofilms on the front and back surfaces. Cleaning with a disinfecting contact lens solution (of any kind), and RUBBING the back and front of the lenses is a key component to getting rid of these biofilms. It does a very good job but sometimes with our microscopes in the office we can see these biofilms accumulate over long-term wear, even if the patient reports good compliance. In the office, to remove this, I take Boston Advance cleaner (the one with the red top that means you CANNOT get it into your eye), and rub the front and back surfaces of the lens. This type of cleaner is abrasive and so it will remove biofilms but it also will remove any coatings (HydraPEG or plasma). I generally recommend this only after lenses are 1 year old because then we know that the coatings have likely already come off naturally on their own. After washing with this solution, I generously rinse the lenses with saline solution. You MUST rinse off every single bit of this solution because you cannot get this solution in your eye. The first lens photo is a scleral lens of a patient that has some film on the back surface. The second photo is after cleaning. You can see that getting off all the film in the deep grooves of the lens isn’t easy! Basic rule is, you must rub your lenses when you wash them. You can use your solution (Tangible Clean) or the saline solution if you soak them in ClearCare. This rubbing removes biofilms. I have started doing these deep cleanings on RGP and Scleral lenses on all annual exams and patients have been loving how clean the lenses feel.” By Caitlin Morrison, OD, FAAO, FSLS (@eyesplain)