OCULAR SURFACE DISEASEPatient Candidacy
Julie Song OD, FAAO, FSLS
Therapeutic Scleral Lens Candidates
- Persistent ocular surface disease signs and symptoms
- Neurotrophic keratopathy1
- Failure with primary and secondary dry eye treatments2
- Neuropathic pain or keratoneuralgia
- Scleral lenses can disrupt the pain cycle for patients who develop a hypersensitivity of the ocular somatosensory nerves following corneal nerve disruption and who have exaggerated scleral and conjunctival pain from secondary hyperalgesia.1, 3-5
- There are generally no age restrictions for scleral lens wear and for patients who struggle with application and removal, there are additional tools on the market that can be utilized to aid patients who have limitations.1
Sources
- 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.
- Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276-283.
- Levitt AE, Galor A, Weiss JS, et al. Chronic dry eye symptoms after LASIK: parallels and lessons to be learned from other persistent post-operative pain disorders. Mol Pain. 2015;11:21. Published 2015 Apr 21.
- Galor A, Zlotcavitch L, Walter SD, et al. Dry eye symptom severity and persistence are associated with symptoms of neuropathic pain. Br J Ophthalmol. 2015;99(5):665-668.
- Rosenthal P, Baran I, Jacobs DS. Corneal pain without stain: is it real? Ocul Surf. 2009;7(1):28-40.
- Foulks GN, Forstot SL, Donshik PC, et al. Clinical guidelines for management of dry eye associated with Sjögren disease. Ocul Surf. 2015;13(2):118-132.