Best Practices for Fitting and Assessing Scleral Contact Lenses

A recent study of practitioners with varying degrees of experience fitting scleral contact lenses gleaned best practices from those with five years of experience, which can be used for lens evaluations and fittings.

Investigators distributed a survey at the 2017 Global Specialty Lens Symposium and received 95 responses to questions about scleral lens fitting assessments and practices. Among the results:

• ~60% had <5 years’ experience fitting scleral lenses; the remainder were more experienced.
• 60% of new prescribers looked at base curve for their initial scleral lens selection, whereas 63% of experienced prescribers considered sagittal depth.
• All experienced prescribers tended to use a slit lamp beam to compare thickness of the post-lens tear reservoir with scleral lens thickness, vs only 62% of less experienced clinicians.
• All experienced prescribers reserved specific times for scleral lens follow-ups during which they assessed conjunctival compression, conjunctival staining, and corneal staining.

The authors noted that their results show that consensus is emerging among more experienced clinicians that might help inform guidelines.

Harthan J,  Shorter E, Nau C, et al.  Scleral lens fitting and assessment strategies.  Contact Lens and Anterior Eye. doi: https://doi.org/10.1016/j.clae.2018.10.020