A pleasant man was kindly referred to us for a specialty contact lens evaluation for both eyes. He has a history of bilateral corneal transplants in both eyes. He also has a shunt in the right eye, due to severe glaucoma.
His ocular surface is very irregular, and we had to switch from the regular 16.0 mm diameter Europa scleral lens set to the 18.00mm diameter because his sagittal depth was so large.
Even with the highest sag lens, you can see that the fit is not optimal. He also has a decentered pupil, which will further limit his vision.
With glasses, his best acuity in the right eye is 20/100 and he complains of ghosting and double vision.
With a diagnostic lens and an over-refraction, we were able to get him to 20/40 vision with less ghosting and double vision.
We are working with visionary optics and designing a custom scleral lens using 3D images of his eye to create a 3D scleral lens.