BCLA CLEAR Episode 5 - Scleral Lenses

This is the fifth episode in the BCLA CLEAR series. Scleral lenses were the first type of contact lens to restore vision and protect the ocular surface. With the advent of rigid corneal lenses in the middle of the twentieth century and soft lenses in the 1970’s, the use of scleral lenses diminished; in recent times there has been a resurgence in their use driven by advances in manufacturing and ocular imaging technology. Scleral lenses are often the only viable form of contact lens wear across a range of clinical indications and can potentially delay the need for corneal surgery. This report provides a brief historical review of scleral lenses and a detailed account of contemporary scleral lens practice including common indications and recommended terminology. Recent research on ocular surface shape is presented, in addition to a comprehensive account of modern scleral lens fitting and on-eye evaluation. A range of optical and physiological challenges associated with scleral lenses are presented, including options for the clinical management of a range of ocular conditions. Future applications which take advantage of the stability of scleral lenses are also discussed. In summary, this report presents evidence-based recommendations to optimise patient outcomes in modern scleral lens practice.

Dr Eef van der Worp discusses some of the key findings of this paper with Dr Melissa Barnett. Eef van der Worp is an educator and researcher. He now runs his own research & education consultancy 'Eye-Contact-Lens' based in Amsterdam (NL). He is on the education committee for a number of international conferences, including the Global Specialty Lens Symposium (GSLS) in the US and the Dutch Contact Lens Conference (NCC) and Dutch Optometric Society meeting (OVN). He is a board member of the BCLA journal Contact Lens & Anterior Eye. Eef is adjunct assistant Professor at Pacific University College of Optometry (Oregon, USA), and adjunct Professor at the University of Montreal University College of Optometry (CA) and he is lecturing extensively worldwide and is a guest lecturer at a number of Universities in the US and Europe.

Dr. Barnett is a principal optometrist at the University of California, Davis Eye Center in Sacramento and Davis, California. She is an internationally recognized key opinion leader, specializing in dry eye disease and specialty contact lenses. She is a Fellow of the American Academy of Optometry, a Fellow of the British Contact Lens Association and serves on multiple Boards. Dr. Barnett is Past President of The Scleral Lens Education Society.

BCLA CLEAR is an initiative that has drawn together thousands of research papers on many different aspects of contact lenses into one place. The findings were published in, Contact Lens and Anterior Eye, the BCLA's scientific journal, in April 2021 under ten reports. BCLA CLEAR was facilitated by the BCLA, with financial support by way of Educational Grants for collaboration, publication and dissemination provided by Alcon and CooperVision.