GSLS 2026: Scleral lens troubleshooting with Dr Elise Kramer

At the Global Specialty Lens Symposium (GSLS) 2026 conference, held from January 7-10 in Las Vegas, Nevada, Elise Kramer, president of the Scleral Lens Education Society (SLS), discussed the focus and goals of her presentation on scleral lenses. In "Scleral Lens Troubleshooting: A Case-Based Walkthrough of the Scleral Fitting Process and Management of Common Hurdles," the session spans from basic principles to advanced troubleshooting, emphasizing both the technical aspects of lens fitting and the management of complications encountered in clinical practice. Kramer gave the presentation alongside Kelsea Skidmore, OD, MS; Vivien Tse, OD; and Elaine Chen, OD.

Kramer notes that scleral lens fitting is often highly individualized and case-based, particularly for patients with complex ocular histories. These include individuals with prior ocular surgeries, very steep or irregular corneas, and other “difficult-to-fit” cases. She highlights that successful outcomes depend on understanding how to design lenses that fit comfortably, remain stable on the eye, and provide optimal vision.

The presentation also covers how to handle a wide spectrum of visual and refractive challenges: very high prescriptions, double vision requiring prism, and multifocal lens designs, including for pediatric patients. By being comprehensive, the talk aims to give practitioners practical tools and frameworks to approach both common and rare complications.

A central message is the importance of hands-on experience. Kramer encourages clinicians not to be paralyzed by theory or intimidation, but instead to “get a lens on the eye” and proceed step by step. She admits that even as an expert she still encounters intimidating cases, but relies on systematic reasoning and her experience to work through them. She underscores that learning continues throughout one’s career.

Kramer also stresses the supportive network available to practitioners. She points to lab consultants and SLS fellows worldwide as valuable resources for troubleshooting complex cases. Even as she transitions from president to past president, she reassures listeners that she remains available for questions and guidance. More broadly, she reiterates that the SLS board is dedicated to education globally, supporting both practitioners and patients in the field of scleral lenses. The overarching theme is collaboration, continual learning, and confidence through practice in scleral lens fitting.