AAOpt 2026: Jamie Kuzniar, OD, on complex scleral lens fitting cases

Jamie Kuzniar, OD, FAAO, FSLS, joined Brooke Messer, OD, FAAO, FSLS, and Jason Jedlicka, OD, FAAO, for a case-based session on scleral lens conundrums at AAOpt 2026. Kuzniar spoke with Optometry Times about the session's format, fitting patients after corneal cross-linking, and her advice for new optometry graduates interested in gaining experience with scleral lenses.

How should clinicians time scleral lens fits around cross-linking?

Before the session, attendees submitted questions about scleral lens cases they found challenging. The panelists covered the causes of potential unexpected outcomes, such as loss of sagittal depth, and walked through how they would manage each case. The session provided clinical pearls attendees could take back to their practice.

The session also covered how to time scleral lens fitting for patients undergoing corneal cross-linking. Kuzniar noted each panelist's perspective reflected the modality they work in and the region where they practice. She said patients who undergo epi-on cross-linking can return to their scleral lenses sooner.

Kuzniar typically begins the fit while the patient awaits insurance approval for the procedure. The patient then stops wearing the lens during the procedure and for a couple of weeks afterward. “In most cases, and this is backed by research, they can go back into that lens, and it doesn't need to have fit changes,” Kuzniar said.

“You don't have to…put your patient's life on pause because they're getting cross-linked,” she continued.

Scleral lens misconceptions and advice for new optometry graduates

Kuzniar pointed out that more optometrists are fitting scleral lenses as the topic becomes more prevalent and ways to learn the technique expand. She encouraged new optometry graduates to have confidence in their experience, as they are coming out of school with more scleral lens training than practitioners had 10 to 15 years ago. That training, she said, gives them the opportunity to join practices that offer the service.

According to Kuzniar, the biggest misconception about scleral lenses is that patients will find them too difficult to handle. She said patients rarely fail lens training, especially when they are motivated. Many providers, she added, worry about whether they will have enough patients who need the lenses and whether those patients will want to wear them, find them comfortable, and be able to handle them. “[Patients] can handle them. You can streamline it into your practice very easily,” Kuzniar said.