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Dr. Travis Zigler on Scleral Contact Lenses

Dr. Travis Zigler on Scleral Contact Lenses

Morning Dry Eye Community! Dr. Travis Zigler here with Eye Love. Wanted to go over a video on Scleral lenses and we’ve had a lot of questions about them in the community. So, wanted to just go over a fitting I just did the other day for a dry eye patient of mine and show you how scleral lens looks from the eye. Obviously this isn’t what it looks like from our perspective but this is a scan that we have in our office called anterior ocular coherence tomography scan or an anterior OCT.  What this does is it gives us a micron looking scan of the front of the eye. What you’re looking at here is right here, I pointed it out for you, is the scleral lens sitting on top of the front surface of the eye. You can think of this person's eye is pointed upwards and then right here is the cornea or the front part of the eye. The cornea is where all the nerve endings are for your eye. There’s five layers to it. You can see all those layers right here. Here’s the big layer called the Stroma and another two layers down here. What you’re looking at here is the scleral lens. We want it to be about three hundred microns of gap between the scleral lens and the cornea. And so, how we compare that is we do the scan. This is just one way to do it, and we compare it to the cornea which is usually about five hundred and fifty five microns on average. So you can see that, that is about a third to a half of this, so I’m guessing this is probably close to two hundred to three hundred microns, which is really good. So, we put in the scleral lens before we put it in the eye. We put preservative free solution and you can see that it constantly bathes the eye all day long.

 

Scleral Contact Lenses

 

That’s why we use strict dry eye because of this. Now, if you have problems with the cornea or the mucin cells of the  conjunctiva, then you might get a lot of debris in this area. You might have to refresh this area every so often through out the day, maybe every four hours or so. Usually what I try to do with scleral lens patients, and what I did with this patient is, we put her on a regimen of warm compresses, we put her on omega-3s, and I actually put her on xiidra and a steroid for about 2 months. After that 2 month period, we then assessed the eye. It looked really clean and really good. Her eyelids look great too. We also put her on the Heyedrate spray as well. Then we put the scleral lens on her just last week and we ordered it. We will keep you updated with the results but she should be back to pick up the lens probably about next week. Let me know if you have any questions on scleral lenses below, and we also wrote a couple of blog articles on it. Again, Dr. Travis Zigler with Eye Love. 

 

0:00:01.719,0:00:02.739
Morning Dry Eye Community!

0:00:02.739,0:00:04.790
Dr. Travis Zigler here with Eye Love.

0:00:04.790,0:00:11.910
Wanted to go over a video on scleral lenses
and we’ve had a lot of questions about them

0:00:11.910,0:00:12.910
in the community.

0:00:12.910,0:00:18.359
So, wanted to just go over fitting I just did the
other day for dry eye patient of mine and

0:00:18.359,0:00:21.740
show you how scleral lens looks on the eye.

0:00:21.740,0:00:25.810
And obviously this isn’t what it looks from
our perspective but this is a scan that we

0:00:25.810,0:00:33.270
have in our office called an anterior ocular
coherence tomography scan or an anterior OCT.

0:00:33.270,0:00:37.970
And what this does is it gives us a micron
looking scan of the front of the eye.

0:00:37.970,0:00:44.660
And so what you’re looking at here is, right
here, I pointed it out for you is the scleral

0:00:44.660,0:00:47.660
lens sitting on top of the front surface of
the eye.

0:00:47.660,0:00:56.080
So, you can think of this person is that their
eye is pointed upwards and then right here is

0:00:56.080,0:00:58.220
the cornea or the front part of the eye.

0:00:58.220,0:01:00.780
The cornea where’s all the nerve endings
are for your eye.

0:01:00.780,0:01:02.280
There’s five layers to it.

0:01:02.280,0:01:04.400
You can see all those layers right here.

0:01:04.400,0:01:09.930
Here’s the big layer called the stroma
and another two layers down here.

0:01:09.930,0:01:13.409
And so, what you’re looking at here is the
scleral lens.

0:01:13.409,0:01:19.250
We want it to be about three hundred microns
thick or excuse me, three hundreds microns

0:01:19.250,0:01:24.000
of gap between the scleral and the cornea.

0:01:24.000,0:01:26.600
And so, how we compare that is we do the scan.

0:01:26.600,0:01:30.680
This is just one way to do it and we compare
it to the cornea which is usually about five

0:01:30.680,0:01:32.670
hundred and fifty five microns on average.

0:01:32.670,0:01:37.270
So you can see that, that is about a third
to a half of this.

0:01:37.270,0:01:40.970
So, I’m guessing this is probably close
to two hundred to three hundred microns which

0:01:40.970,0:01:42.590
is really good.

0:01:42.590,0:01:47.670
So, we put in the scleral lens before we put
in the eye.

0:01:47.670,0:01:52.560
We put preservative free solution and you
can see that it constantly bathes the eye

0:01:52.560,0:01:53.560
all day long.

0:01:53.560,0:01:57.299
And so that’s why we use it to treat dry eye
because of this.

0:01:57.299,0:02:05.890
Now if you have problems with the cornea or
the mucin cells of the conjuctiva then you might

0:02:05.890,0:02:08.170
get a lot of debris in this area.

0:02:08.170,0:02:12.150
You might have to refresh this area every
so often through out the day maybe every four

0:02:12.150,0:02:13.440
hours or so.

0:02:13.440,0:02:17.891
So usually what I try to do with scleral lens
patients, and what I did with this patient is, we

0:02:17.891,0:02:24.640
put on a regimen of warm compresses,we put
her on omega-3s, and I actually put her on

0:02:24.640,0:02:27.840
xiidra and a steroid for about 2 months.

0:02:27.840,0:02:31.370
After that 2 month period, we then assessed
the eye.

0:02:31.370,0:02:33.120
It looked really clean and really good.

0:02:33.120,0:02:34.260
Her eyelids look great too.

0:02:34.260,0:02:39.730
We also put her on the Heyedrate spray as well
and then we put the scleral lens on her just

0:02:39.730,0:02:42.170
last week and we ordered it.

0:02:42.170,0:02:46.239
And we will keep you updated with the results but
she should be back to pick up the lens probably

0:02:46.239,0:02:47.900
about next week.

0:02:47.900,0:02:52.569
So let me know if you have any questions on
scleral lenses below, and we also wrote a couple

0:02:52.569,0:02:54.130
of blog articles on it.

0:02:54.130,0:02:55.719
Again Dr. Travis Zigler with Eye Love.

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