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GP lens eye Rounds

OCULAR SURFACE DISEASE: Conditions

Julie Song OD, FAAO, FSLS

According to the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) II Report on Dry Eye Disease, dry eye treatment and management can be staged into four separate steps.1 Therapeutic contact lens options fall under step 3 for dry eye management and include soft bandage lenses and rigid scleral lenses.1 Fitting scleral lenses for corneal irregularity still accounts for the majority of scleral lens fits at 74% according to the Scleral Lenses in Current Ophthalmic Practice Evaluation (SCOPE) study group.2 According to SCOPE, only around 16% of scleral lenses are prescribed for therapeutic indications.2 As more research studies are performed on therapeutic scleral lenses, and as the fitting techniques become more advanced, this percentage is likely to rise over the coming years. While the list of indications may continue to grow over time, below are a list of therapeutic indications for scleral lenses:2-3

  • Sjogren’s Syndrome
  • Exposure Keratopathy
  • Neurotrophic Keratopathy
  • Limbal Stem Cell Deficiency
  • Graft-versus-host Disease
  • Post-penetrating Keratoplasty
  • Persistent Corneal Epithelial Defects
  • Keratoconjunctivitis Sicca
  • Salzmann’s Nodular Degeneration
  • Filamentary Keratitis
  • Anterior Basement Membrane Dystrophy
  • Cicatrizing Conjunctivitis
  • Superior Limbic Keratoconjunctivitis

Sources

  1. Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276-283.
  2. Harthan JS, Shorter E. Therapeutic uses of scleral contact lenses for ocular surface
    disease: patient selection and special considerations. Clin Optom (Auckl). 2018;10:65-74. Published 2018 Jul 11.
  3. Kawulok E, Schornack M, Nau CB, Guier C, Wentz C; Multicenter Review of Indications for Scleral Lens Wear. Invest Ophthalmol Vis Sci. 2021;62(8):676.
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