Discomfort with a Scleral Lens
We saw one of our keratoconus patients for a follow up this week for her custom scleral lens on her left eye.
She states that the vision is excellent, but the lens is slightly uncomfortable inferiorly.
She can see 20/25 in her Latitude Custom Scleral lens, and the fit overall looks very good.
The only issue seen was some inferior conjunctival chalasis. This can happen with scleral lens patients where the thin membrane covering the sclera (called the conjunctiva) can bunch up and become swollen.
You can see it slightly when assessing the lens. To confirm this, I like to use the OCT and have the patient look up or straight ahead and capture the limbal clearance.
You can see there is definitely some chalasis inferiorly and the limbal clearance is also a bit excessive. My plan is to decrease the limbal clearance by designing a new lens.
Hopefully this will resolve the chalasis and also improve her comfort!