Following the patient's lead on wavefront-guided scleral lenses with Dr Jamie Kuzniar

According to a recent poster presented at the Global Specialty Lens Symposium (GSLS) 2026, the Zenlens Chroma HOA lens (Bausch + Lomb) provides patients with keratoconus a specialty lens option that supports stability and centration and improved visual outcomes. Jamie Kuzniar’s, OD, FAAO, FSLS, poster, "Enhancing visual quality in keratoconus: Outcomes with wavefront-guided scleral lenses," provided a follow-up report to previous fitting findings for the lens and was presented during the conference, which ran from January 7-10 in Las Vegas, Nevada. She sat down with Optometry Times to detail what attendees at the conference took away from the presentation.

Can you provide an overview of your poster presentation?

Jamie Kuzniar, OD, FAAO, FSLS:

So last year, I had a poster published of some of my first patients that we were able to manufacture with a lens called Zenlens Chroma that had really good, really great outcomes. This year is almost like a follow-up poster, now that we really fine-tuned everything with manufacturing. And even I've gotten better myself with candidacy, selection, fitting the lenses, and we've had even a better outcome for my keratoconus patients. So on average, between my whole case series of patients, we saw an improvement of 73.5% of average [high order abberations, or] HOAs across all the eyes, which was phenomenal. And we know with keratoconus, the main ones that affect them are something called coma and spherical aberration. So I basically screened my scleral lens patients for any large amounts of coma or spirit collaboration, and the ones that showed significant issues with those that we talked about doing an HOA lens and got them going with chroma, and they're all super, super happy. Their vision improved dramatically, subjectively and objectively when we measure them with visual acuity.

What makes this lens different than the others? What is unique about its technology?

Kuzniar:

So the thing that I really felt like made this lens different is that the stability of Zenlens is really great, especially when we use by elevation, because it just really locks in the optics. Because the issue with HOA is it's phenomenal technology, but if that lens rotates a few degrees on the eye throughout the day, it's making their vision fluctuate quite a bit. So you really need a lens that can just be very stable once you have it on the eye and it just locks in. That way, they can really precisely line up the optics right over their pupil, right where it should be. Also, getting better centration of the lens in general does help a lot with HOAs as well.

What makes this lens optimal for keratonic patients?

Kuzniar:

So the thing I like the most is that, 1: of course, the stability; 2: I feel like I can really, truly customize it to each of my patients in general, not just with keratoconus, but with any corneal condition at all. So I've always had really great success with really comfortable fits for my patients, the landing zone is very generous, so they tend to have more subjective comfort when I put them as well, so a little bit better wearing time.

What do you hope other eye care providers are able to take aways from this presentation?

Kuzniar:

The main thing that practitioners can take away is, if you're not doing HOA sclerals, we need to start this is definitely a need that is out there, and we know that it will make a huge difference for our patients. It's just there's not a lot of access right now. So I have patients that drive from far distances because they want these lenses, they want the technology, and we know that it works. So this is more proof that it does work. It does make them happy, both on the visual acuity chart, but also just subjectively in their life, with nighttime driving visual clarity. So it's just more proof and encouragement that this technology does make a huge difference in them. And if we're not doing it, maybe it'll give us a little extra push to jump out there and start fitting these lenses for our patients.

What's interesting is, like I was saying, if we're not fitting these lenses, your patients will find someone who will and actually, some of these patients that I use in my case study, they found me online because they know about the technology before some doctors do. So there are patients out there doing their own research, and a couple of these patients just found me online because they knew I could offer it. So a lot of times, we think our patients are happy and they are grateful. They're super grateful that we put them in scleral lenses and their visions improved greatly, but they want even more. So I think if we can at least offer that to them or educate them about the technology, whether or not you offer it in your office or maybe a colleague locally, does that'd be great. But the more and more knowledgeable patients get, now that there's access on the internet and with articles and webinars that they can see, they know about these things. So just keep that in the back of your mind is, you know, patients are becoming more educated, which is just a great thing, and we just need to rise to the occasion and help them out with what they need.