Succeeding With Sclerals

Healthy corneas normally bend incoming light toward the retina so we can see clearly. However, certain corneal conditions, such as keratoconus and astigmatism, lead the light’s path to the cornea to diffuse, resulting in reduced and blurred vision.

That’s precisely what happened to three patients: Ben, Georgette and Fred, who have irregular corneas that caused them to struggle with their vision. Thanks to scleral lenses, they and countless other patients with corneal conditions have experienced improved visual clarity, sharper focus and unparalleled comfort. But before we delve into their stories, what are scleral lenses and how exactly do they benefit those with irregular corneas?

Irregular Corneas and Scleral Lenses

Irregularly shaped corneas are most commonly caused by or associated with astigmatism, keratoconus, prior eye surgeries (such as LASIK, cataracts, corneal transplant), trauma, scarring and pellucid marginal degeneration.

Irregular corneas cannot be corrected with eyeglasses or traditional contact lenses. An excellent non-surgical solution is scleral lenses, which provide clear vision and better comfort while keeping your eyes hydrated throughout the day.

The lenses vault over the cornea and rest on the sclera, the white part of the eye, which prevents corneal irritation. The liquid reservoir fills in the surface irregularities of the cornea, restoring vision and enabling the eye to comfortably heal. The smooth optical surface replaces the distorted corneal surface, resulting in dramatically improved vision and comfort.

Read how scleral lenses have helped address Ben’s, Georgette’s and Fred’s irregular corneas, and enabled them to experience improved vision and a higher quality of life.

*These patient testimonials are meant to reflect actual testimonials of patients but not necessarily our patients.

Everything Is Now in Focus for Ben

Ben entered college excited for life’s newest adventure. He made friends and studied hard. But his struggle to read the content on the classroom whiteboard and in his textbooks presented the same challenges he’d experienced for much of his life.

“Here we go again,” Ben thought. Ben had astigmatism, meaning that his corneas were unevenly curved. As a result, images and texts appeared blurry. To see clearly, he resorted to squinting, which, in turn, led to frequent headaches.

Although Ben had regularly been updating his eyeglass prescription over the years, and tried wearing standard contact lenses, he still struggled with his vision. “Enough is enough,” Ben decided. “It’s time to consult a vision expert!”

That’s when Ben went to see his eye doctor, who suggested he wear scleral lenses to help see clearly with his astigmatism.

The scleral lenses worked wonders by allowing Ben’s eyes to properly focus light to the retina. Several appointments with his eye doctorensured that the scleral lenses were fit just right. Ben can now see clearly and effortlessly, read the board and his textbooks, all of which have enabled him to graduate from college with honors.

If you or your child have astigmatism, make your life easier by following in Ben’s steps and ask Dr. Michael Antoine, O.D. about scleral lenses.

For Georgette, Sclerals Are the Perfect Fit

Just imagine how Georgette felt, at age 15, when she was diagnosed with keratoconus.

No one wants to hear that their cornea is thinning and gradually bulging outward into a cone shape. But that’s exactly what happened to Georgette. Because keratoconus causes blurred vision and sensitivity to light, Georgette often found herself squinting to help her see clearly.

That’s when her eye doctor suggested scleral lenses. Having never worn contact lenses, Georgette hesitated, then reconsidered. “Let’s do it,” she concluded.

Georgette left her eye doctor with her new pair of custom fit scleral lenses, fully excited at the prospect of experiencing great vision. Thanks to sclerals, she not only sees clearly, but now finds her eyes to be significantly less sensitive to light, which allows her to enjoy the outdoors during the day.

Fred Likes What He Sees Following His Corneal Transplant

“It still hurts,” Fred complained as he looked into his eyes in the mirror.

The corneal transplant he underwent 10 months earlier effectively addressed his corneal scars following a workplace accident. Fred recovered as the operation’s physical effects receded. Post-operative medications prevented not only inflammation and infection, but also the rejection of his newly transplanted corneas. However, the standard contact lenses he began using a few months after the transplant were painful to wear, and his irregular astigmatism—far from corrected—continued to cause fluctuating vision.

Imagine Fred’s excitement at learning that scleral lenses enable clear and painless vision for keratoplasty (corneal transplant) patients like himself. He read a 2016 study published in the Eye & Contact Lens journal that found that sclerals in post-keratoplasty patients are safe and effective, with most patients attaining 20/40 vision or better.

How did things turn out? With attentive care, really well. Fortunately, Fred now experiences both comfort and excellent vision with scleral lenses.

REFERENCES

• https://www.aao.org/eye-health/diseases/what-is-keratoconus
• https://www.allaboutvision.com/contacts/scleral-lenses.htm
• https://www.aao.org/eye-health/ask-ophthalmologist-q/will-keratoconus-stop-progressing-after-age-25
• https://pubmed.ncbi.nlm.nih.gov/26214530/

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Scleral Lenses for Astigmatism

Scleral lenses are a great nonsurgical solution that provides exceptional vision correction in patients with astigmatism, whether by birth, due to post-refractive surgery, or other corneal procedures. Astigmatism is a refractive error caused by irregular corneal curvature, resulting in blurred and distorted vision. Scleral lenses allow astigmatic patients to experience improved visual acuity and comfort while keeping eyes hydrated all day.

If you have been told that your astigmatism is too severe to wear contacts, ask Dr. Michael Antoine, O.D. about scleral contact lenses. At the Antoine Eye Care Scleral Lens Center in St. Louis, we work hard to give each patient a superior contact lens fit and know that these lenses can truly make a difference in our patients’ lives.

What is Astigmatism

Astigmatism is a common type of refractive error caused by an irregularly shaped cornea. The abnormal cornea causes light to enter unequally onto the retina, which results in blurred or distorted vision, eye strain, headaches, squinting and eye irritation. People are either born with this condition or can develop it later in life.

This condition typically occurs with myopia (nearsightedness) or hyperopia (farsightedness) and can be easily diagnosed using a simple eye exam.

Astigmatism falls into three categories:

• Myopic (nearsighted) astigmatism: For the myopic, light rays focus in front of the retina, leading objects in the distance to appear blurred. Myopic people who have astigmatism experience further blurring and vision distortion due to the refractive error caused by mismatched curvatures of the cornea or lens.
• Hyperopic (farsighted) astigmatism: For the farsighted, light focuses beyond the retina. Individuals with hyperopia and astigmatism experience blurred and distorted vision and have difficulty focusing on objects that are up close.
• Mixed astigmatism: In people with mixed astigmatism, one curvature of the cornea or lens focuses light to the front of the retina while the other focuses light to the back of the retina.

Astigmatism falls into the regular or irregular camp:

Most cases of astigmatism are regular, meaning that the front surface of the eye is oval-shaped. Irregular astigmatism is often caused by scarring of the cornea, keratoconus or from certain types of eye surgeries.

Can People With Astigmatism Wear Contact Lenses?

In cases of moderate to severe astigmatism, sometimes the distortion is too severe to be compensated for properly by soft contact lenses, which simply conform to the irregular shape of the cornea. Scleral lenses, on the other hand, sit on the sclera – not the cornea. They are rigid and maintain their shape regardless of the corneal dimensions. This allows the eye to properly focus light and thus ensures the sharp vision and exceptional comfort. The liquid reservoir that gets trapped underneath the scleral lens masks corneal astigmatism and ensures a stable fit.

What are Scleral Lenses?

Scleral lenses get their name from the way they fit on the eye. The sclera is the white part of the eye, and these lenses rest on the sclera while the lens itself vaults over the cornea.

Scleral lenses have become an important therapeutic strategy in the visual rehabilitation of patients with irregular corneas, such as astigmatism. The liquid reservoir between the lens and the cornea neutralizes astigmatism and provides a continuous moist environment that protects the cornea from exposure to air and friction from blinking.

Scleral lenses offer better comfort, breathability and improved visual acuity due to their rigid optical surface and a shape designed specifically for each patient’s eye. We have found that for our patients with astigmatism, scleral lenses have proven to be the best solution in providing sharp and comfortable vision all day long.

Are Scleral Lenses for Astigmatism Expensive?

Scleral lenses are custom-fit to each eye, and though the fees for fitting scleral and the cost of the lenses are higher than traditional lenses, their life span and benefits offset the costs.

Coverage rates and restrictions vary among providers, and if considered a medical necessity, many insurance companies will cover the cost of scleral lenses. That said, every country and state has its own restrictions and regulations. Consult with our eye care team at the Antoine Eye Care Scleral Lens Center to discuss your specific payment options and cost of scleral lenses.

Specialized optometrists, such as Dr. Michael Antoine, O.D., are trained in fitting scleral lenses for excellent, effective vision correction, and help patients with astigmatism and other corneal irregularities enjoy great vision and comfort with specialty lenses.

TESTIMONIAL:

“ I went to the Antoine Eye Care Scleral Lens Center for my astigmatism, and I’m so grateful to the staff and doctors for their thorough care! They meticulously fitted me for scleral lenses, and now I can not only see well, but I tend to forget I’m wearing lenses. They’re so very comfortable! “

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Scleral Lenses For Keratoconus And Other Eye Conditions

The cornea, which is the clear tissue on the eye’s outermost surface (covering the pupil and the iris), bends and focuses light going into the eyes. However, for those with irregularly-shaped corneas, the light entering the eye is not properly focused — which results in distorted vision.

Thankfully, scleral lenses offer excellent visual acuity and comfort for those with corneal irregularities, due to their large shape, unique features and customized fit.

Scleral Lenses for Keratoconus

Keratoconus (keh-rah-toe-cone-us) is an eye disorder in which the round dome-shaped cornea progressively thins, causing a cone-like bulge to develop.

Because patients with keratoconus have irregular, cone-shaped corneas, glasses cannot be used to properly correct vision. The ideal solution, therefore, are scleral contact lenses. They sit on the sclera without touching the cornea, while providing sharpness, clarity and comfort.

Scleral Lenses for Severe Dry Eye

People suffering from severe dry eye can find therapeutic benefits from transitioning to custom designed scleral lenses. Scleral lenses tackle three factors simultaneously: they provide vision correction, they protect the eye, and they serve a therapeutic purpose by lubricating the eye.

Scleral lenses also decrease pain, discomfort, eye redness and itchiness in those with dry eyes.

Scleral Contact for Astigmatism

Astigmatism is a refractive error caused by irregular corneal curvature, resulting in blurred and distorted vision. Scleral lenses offer exceptional vision correction in patients with astigmatism, whether by birth, following post-refractive surgery, or due to other corneal procedures. The lenses improve visual acuity and comfort while keeping eyes hydrated all day long.

Scleral Lenses for Myopia and Presbyopia

Scleral contacts are ideal for anyone with severe nearsightedness or farsightedness. For presbyopic patients, scleral contacts can be designed as multifocal contacts to correct nearsightedness and farsightedness simultaneously. Because scleral lenses are firmly positioned on the eye, they provide significantly more comfort when compared to standard multifocal lenses.

Mini Scleral Contacts Vs. Full-Size Scleral Contact Lenses

All scleral lenses rest on the white part of the eye, the sclera. However, Dr. Michael Antoine, O.D. will customize the scleral lenses by determining the exact diameter and space needed between the cornea and sclera. Certain scleral lenses may have a space of a few millimeters (mini scleral lenses), while standard scleral lenses are larger, full-sized lenses. Larger scleral lenses are typically recommended for highly irregular corneas.

Ask Us About Scleral Lenses

If you struggle with keratoconus, astigmatism, dry eyes or any of the other conditions listed above, ask your Antoine Eye Care Scleral Lens Center doctor about scleral lenses. Dr. Michael Antoine, O.D. will patiently assess and explain your condition to you, and will perform a specialized, scleral lens custom-fitting to ensure that you receive the best fit for optimal visual clarity and comfort.

Call the Antoine Eye Care Scleral Lens Center today to schedule your consultation.

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Scleral Contact Lenses for Sjogren’s Syndrome

What Is Sjogren’s Syndrome?

Sjogren’s syndrome is an autoimmune disease that causes extreme dryness that affects much of the body, including the eyes. In addition to dryness of the mucous membranes, Sjorgren’s syndrome can cause pain, exhaustion, nerve damage and blood cancer.

About 4 million Americans have the disease, 90% of them women. An additional 3 million may be living with the disease without knowing it, according to the Sjogren’s Syndrome Foundation. In fact, an estimated 1 in 10 patients with dry eye symptoms have Sjogren’s syndrome.

Why Sjogren’s Syndrome Causes Dry Eyes

Individuals with the syndrome have inflammation of the lacrimal glands, which causes them to produce a lower quantity of tears. Lower tear volume means that irritants that would ordinarily be washed away by tears remain on the ocular surface, leading to inflammation, irritation and, if left untreated, corneal scarring.

Many individuals with Sjogren’s syndrome also have other autoimmune diseases, such as lupus, celiac disease or rheumatoid arthritis.

Eye Symptoms Related to Sjogren’s Syndrome

In those with Sjogren’s syndrome, having dry eyes is a given.

Other common symptoms include:

• Burning eyes
• Sensitivity to light
• Blurry vision
• Eye strain and fatigue
• Blepharitis – an inflammation of the eyelids
• Discomfort while wearing regular contact lenses

How Is Sjogren’s Syndrome Diagnosed?

Because the symptoms are varied and develop gradually, it can take several years for those with Sjogren’s syndrome to be diagnosed with the disease.

However, eye doctors are often the first to suspect the condition since dry eyes are a key symptom of the disease.

After taking your medical history and providing a thorough eye exam, your eye doctor may perform the Schirmer’s test to see whether your tear glands are working properly.

During the test, the eye doctor will place special paper inside your lower eyelids while you keep your eyes closed for a few minutes. Once the paper is removed, the doctor will measure the amount of liquid on the paper.

Another test, which uses dye to make your tears more visible, measures how quickly your tears evaporate.

How Scleral Lenses Alleviate Dry Eyes

Individuals with dry eye syndrome, whether caused by Sjorgren’s syndrome or another condition, often complain that traditional contact lenses irritate their eyes. That’s because traditional contacts dry out easily and compensate by drawing moisture away from the eye.

Scleral lenses, which are gas-permeable, do the exact opposite. They form a protective dome over the cornea that conserves saline solution. The solution acts as a liquid buffer between the lens and the cornea’s surface. That, in turn, alleviates the irritation, itchiness and redness that are the hallmarks of dry eye.

Due to their larger diameter and custom fit, scleral lenses don’t move around as much as conventional lenses. This boosts visual acuity and reduces irritation.

If your eyes feel parched and gritty, contact Dr. Michael Antoine, O.D. for a comprehensive eye exam to determine whether you have dry eye syndrome and to discuss whether your symptoms could be due to Sjorgren’s syndrome.

Call the Antoine Eye Care Scleral Lens Center today to schedule your consultation.

References:

• https://www.healio.com/ophthalmology/news/…/factors-separate-sjgrens-syndrome-from-simple-dry-eye
• http://www.ocularsurface.com/graphics/PDFs/FLUORESCEIN_CLEARANCE_TEST_T3001.pdf
• https://www.hopkinsmedicine.org/health/conditions-and-diseases/sjogrens-syndrome/sjogrens-syndrome-diagnosis
• https://www.contactlenses.org/scleral.htm

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Scleral Lenses for Giant Papillary Conjunctivitis (GPC)

Giant Papillary Conjunctivitis (GPC) is an inflammatory reaction that occurs on the eyelids when proteins are secreted in your tears. These proteins then form a filmy coating on contact lenses that not only makes wearing them uncomfortable but also irritates the eyelids, causing an inflammatory reaction.

In the initial phase of the condition, the inside of your eyelid may become red, itchy, swollen and irritated, but as time goes on, bumps (also called papillae) will develop, occasionally growing to the size of a pimple. GPC can thus make wearing contact lenses irritating and uncomfortable.

Fortunately, GPC isn’t permanent. Wearing scleral lenses not only reduces GPC’s effects but, unlike other lenses, can prevent a recurrence. If you suspect that you have GPC or are simply interested in seeing whether scleral lenses are right for you, speak with Dr. Michael Antoine, O.D. today.

What Causes GPC?

• Wearing certain types of contact lenses heightens the risk of developing GPC
• Protein deposits or other substances on the contact lenses
• A contact lens, artificial eye, or exposed stitches that rub against the lower eyelid
• An allergic reaction to either contact lenses or their cleaning products
• Asthma, hay fever, or other allergies coupled with the use of contact lenses

Can People With GPC Wear Contact Lenses?

Yes. However, those with GPC have more difficulty finding a contact lens that doesn’t further exacerbate the irritation.

Gas permeable (GP) lenses, such as scleral lenses, are highly recommended since proteins don’t accumulate on GP lenses the way they do on soft lenses. This ensures that gas permeable lenses remain cleaner and are therefore less likely to cause an inflammatory reaction.

Another alternative is daily disposable lenses, as they are discarded after a single day of wear. This prevents protein deposits from accumulating on the lenses.

Monthly soft lenses tend to retain protein deposits over time, no matter how well they’re cleaned on a daily basis.

Scleral Lenses for GPC

Due to their large size, scleral lenses are more stable on the eye than conventional GP lenses, and are therefore less likely to dislodge from the eye. Moreover, all scleral lenses are customized and made with highly breathable gas permeable material so that plenty of oxygen reaches the front of the eyeball. The reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a moist environment. It’s no surprise that scleral lenses consistently rank at the top of the charts when it comes to providing sharp visual acuity, comfort and healthy eyes.

Why Do Scleral Lenses Help Prevent GPC?

The customization of scleral lenses is one of the key factors in preventing GPC. Because the lens is properly fitted to the specific eye, and the vault over the cornea is filled with artificial tears, it prevents debris from entering while soothing GPC symptoms simultaneously. Furthermore, those who have highly sensitive eyes and are prone to experiencing allergic reactions can benefit from wearing scleral lenses, as they protect both the tear film layer and are easier to clean than other GP lenses.

Speak with Dr. Michael Antoine, O.D. to learn how to care for your lenses and avoid developing GPC. If you’re susceptible to getting GPC, make sure to schedule follow-up visits with Dr. Michael Antoine, O.D..

Can GPC Develop in Scleral Lens Wearers?

Although the chances are much lower than in conventional contact lenses, giant papillary conjunctivitis may at times develop with scleral lenses due to potential lens surface debris buildup. For those with allergies, it is ideal to use a peroxide cleaning solution as it provides in-depth disinfection.

Make sure to regularly visit Dr. Michael Antoine, O.D. to have your cornea monitored in order to prevent GPC from worsening or recurring.

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