1. A Guide to Identifying Potential Scleral Lens Patients Sept 20, 2014 Natalie Santelli, MAT, OD

2. The BIG Picture An introduction to scleral lenses Goals of Treatment Indications for Treatment Presenting Scleral Lenses to Patients

3. What are scleral lenses?

4. 1508 Leonardo daVinci 1888 Adolf Fick Blown Glass “Vessicle” 1888 Eugene Kalt Glass CTL with KCN 1889 August Mueller Glass CTL high myopia 1900 ’s PMMA Scleral Lenses & impression molding 1970’s Gas Permeable Scleral Lenses

5. Gas Permeable Lens Labs

6. Terminology Names Alternative Names DiameterBearingTear Reservoir Corneal8.0 to 12.5 mmAll on corneanone Corneo-Scleral Corneal- Limbal Semi-Scleral Limbal 12.5 to 15.0 mm Shared b/t the cornea and sclera Limited capacity (Full) ScleralHaptic 15 to 25 mm Mini vs Large (>18 mm) Scleral All on Sclera Somewhat limited to unlimited tear reservoir capacity

7. Goals of Scleral Lens Treatment Reduce symptoms and support healing by restoring a healthy ocular surface environment Improve blurry vision by masking surface corneal irregularities and transmitting a sharper image to the retina Prevent damage by protecting the cornea against the environment and eyelids

8. Indications for Scleral Lens Treatment Vision Improvement – Correcting the irregular cornea: Keratoconus, ectasia, post-LASIK, corneal trauma/infections, post corneal transplants (PKP), high myopia/hyperopia Corneal Protection – Exposure keratitis/ocular surface disease patients – Sjögren’s Syndrome – Persistent Epithelial Corneal Defects – Steven’s Johnson Syndrome – Graft Versus Host Disease (GVHD) – Ocular Cicatricial Pemphigoid – Neurotrophic Corneal Disease – Atopic Keratoconjunctivitis Pharmaceutical Delivery – Antibiotic coverage while a persistant epithelial defect heals – Reduce corneal neovascularization with anti-VEGF medications – Pain mediation with low levels of sodium channel modulators

9. Theses next slides will expand upon the indications for scleral lenses as mentioned in the previous slide

10. Keratoconus & Scleral Lenses

12. Restoring Vision, Restoring Lives

14. THANK YOU!