A multicenter, prospective, cross-over study that compared patient satisfaction outcomes between a soft toric lens design and a large-diameter GP lens design found that patients subjectively report better acuity while using a computer and performing other near tasks when wearing prescribed large diameter GP lenses.11 Therefore, it is foreseeable that even a single vision scleral lens design may potentially help to defer the need for multifocal optics.
Nonetheless, for presbyopic patients who require more accommodative assistance, multifocal scleral lenses are becoming a great clinical addition to our optometric armamentarium. Not only can scleral lenses help these patients who often have concomitant dry eye, there are numerous multifocal scleral lens options that provide exceptional vision across multiple visual ranges.16 Aspheric, center distance and center near designs are just a few of the multifocal lens options (Figures 5A, 5B; Figure 6).
Because scleral lenses protect and bathe the ocular surface, they are fantastic for patients who have been clinically diagnosed with dry eyes and/or have suffered poor on-eye contact lens performance related to their tear deficiencies. As the patient profile complexity increases, scleral lens designs become exceedingly one of the first treatment options for us to recommend to patients. Therefore, it is no wonder that one of our top indications for scleral lens in healthy eyes is a patient with astigmatism, presbyopia, and dry eye.
Moving into sclerals
Today’s scleral lenses are an ideal way to expand a contact lens practice. Start with your existing patients with normal, healthy eyes, especially when vision, comfort, or both are suboptimal with patients’ habitual contact lens modalities. Educate these patients on the benefits and risks of scleral lenses and help them set proper expectations with regards to the scleral lens fitting process.
You can offer this incredible technology to patients with astigmatism, athletic demands, dry eyes, allergies, presbyopia, or simply to improve vision and/or comfort compared to their habitual contact lenses.
Many professional resources exist to help clinicians obtain the latest developments in this field, including The Scleral Lens Education Society (www.sclerallens.org) and International Keratoconus Academy (www.keratoconusacademy.com).
Whether patients have regular corneas or existing corneal pathologies, scleral lenses can positively impact the lives of many of our patients. And in return, our optometric profession will be enriched with the satisfaction of delivering the best care that our patients deserve.
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http://acaai.org/news/facts-statistics/allergies. Accessed 6/12/17.
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