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Scleral Lens Technology: Wavefronts, Impressions, and More

How do we offer our patients the highest levels of scleral lens technology? Here are my top three pieces of equipment and/or software that help me fit specialty lenses more accurately and quickly.

Scleral topography and scan-based lens design software:

You have probably heard of scleral topography. It has been gaining popularity and many doctors, including myself, have it and love it.

Scleral topography takes scans of the cornea and sclera. This technology typically uses multiple scans of the eye (one newer version uses only single scan) and stitches them together to make a rendering of the eye to show scleral elevation data on a more “3-D” level.

I implemented this piece of technology (the scleral topographer) and software (to design and order scan-based scleral lens designs) because I knew it would help fit my patients more efficiently and reduce the amount of lens remakes, especially with patients who have had difficulties with fit.

In my experience so far, my patients love seeing this technology. I use it to explain the need for customized peripheral curves and I use the data to order conventional lenses with toric and quadrant-specific peripheral curves, as well as lenses with toric limbal elevations.

The software to design scan-based scleral lenses can be integrated to use with many different manufacturers, each with their own scan-based lens design. This creates a more customized lens for the patient which can result in improved comfort, centration, and fit of the lens.

Impression-based scleral lenses:

This is another great piece of technology that helps me treat patients with severe corneal irregularities or ocular disease.

Impression-based scleral lenses that are designed by taking an impression of the eye using molding material, scanning the impression into software, and cutting the lens. This creates a highly customized and incredibly specific, comfortable, and stable lens for the patient.

After implementing this technology in my office in early 2020, impression-based lenses quickly became one of my most popular lenses. They are a great tool to have for patients with highly irregular scleras or large tissue mounds who find conventional scleral lenses still uncomfortable, even after many iterations.

Patients with large pingueculas, glaucoma surgeries, or post-surgical scleral abnormalities can benefit from the specificity of using a direct impression to design the lens. After impressions are taken, they are sent to the lab where the molds are scanned into a digital file and cut by a lathe to produce extremely custom lenses, which mean they can be used for those who have “failed” other types of scleral lenses due to discomfort.

Wavefront aberration correction:

Wavefront aberrometers are considered one of the highest level of optical correction. These are machines that observe rays of light as they travel through the eye, bounce off the retina, and come back to the machine to quantify the amount of aberration (spreading of light from point to point) in the visual system.

Lower order aberrations are the well-known refractive errors such as sphere and cylinder. Higher order aberrations such as coma and trefoil can cause what patients describe as “glare”, “halos”, or “comet-like tails on lights.” Both types of aberrations are now able to be corrected with a scleral lens using different aberrations throughout the lens.

Have you heard of these types of technologies? If you or someone you know could benefit from specialty contact lenses designed specifically for you, book a consultation today.

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