We have witnessed a rise in clinical utilization of scleral lenses in recent years, and in some cases, their clinical indications have expanded to include even those patients with regular corneas. Given this sharp rise in scleral lens utilization, the principle of lens selection continuum as proposed by Visser et al appears to also hold true in patients with normal healthy eyes. Thus, when should clinicians reach for scleral lenses when providing care to patients with regular corneas?
Best practice guidelines are just that—guidelines. They’re not religious dogma designed to herd everyone into the same line. We are rightly moving toward more evidence-based medicine, such as increased use of bandage lenses and less pressure patching in the management of corneal abrasions and erosions.