Modern scleral contact lenses: a review

Abstract

Scleral contact lenses (ScCL) have gained renewed interest during the last decade. Originally, they wereprimarily used for severely compromised eyes. Corneal ectasia and exposure conditions were the primaryindications. However, the indication range of ScCL in contact lens practices seems to be expanding, andit now increasingly includes less severe and even non-compromised eyes, too.All lenses that partly or entirely rest on the sclera are included under the name ScCL in this paper;although the Scleral Lens Education Society recommends further classification. When a lens partly restson the cornea (centrally or peripherally) and partly on the sclera, it is called a corneo-scleral lens. A lensthat rests entirely on the sclera is classified as a scleral lens (up to 25 mm in diameter maximum). Whenthere is full bearing on the sclera, further distinctions of the scleral lens group include mini-scleral andlarge-scleral lenses.This manuscript presents a review of the current applications of different ScCL (all types), their fittingmethods, and their clinical outcomes including potential adverse events. Adverse events with these lensesare rare, but the clinician needs to be aware of them to avoid further damage in eyes that often are alreadycompromised. The use of scleral lenses for non-pathological eyes is discussed in this paper