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Can Glaucoma Patients Wear Scleral Lenses?

We have a lot of patients with glaucoma who wear scleral contact lenses. Scleral lenses will not help glaucoma progression, and the reason they use scleral lenses is not for their glaucoma.

Many glaucoma patients suffer from dry eye syndrome. This is due to the preservatives in the glaucoma drops. When you use eye drops with preservatives on a constant basis, it can damage the surface of your eye and create dry eye.

OS sup bleb

Dry eye is very frustrating for most patients. Symptoms include red, itchy, irritated eyes. Many patients complain that their eyes water all the time. Others tell me that they feel like they have sand in their eye.

When patients have extreme dry eye, the surface of their eye (called the cornea) develops damaged dry spots. Think of these dry spots like pot holes on a street. These dry spots are damaged or dead cells on the cornea, and need time to regenerate. However, with the use of preservatives making contact with the eye over and over and over again, it creates a vicious cycle, and the eye can not keep up with the healing process.

eyeprint impression from large bleb

The great news is that we have technology now called scleral lenses that can help with extreme dry eye. Scleral lenses are filled with non-preserved saline, and then applied to the eye like a contact lens. Then, the patient wears the scleral lens all day and the liquid stays in contact with eye, creating a soothing environment. This allows the front surface to heal, and it will make your eyes feel much more comfortable during your waking hours.

We are grateful for a kind referral of a glaucoma patient by Dr. Amram from Meadows Eye.

Dr. Amram and his colleagues at Meadows Eye have been managing this 82 year old patient for years due to severe glaucoma, macular degeneration, and dry eye. She's had multiple surgeries in both eyes due to glaucoma. She has a very large trabeculectomy (which you can see in the photo) in the left eye.

The main reason she was referred to us is due to her extreme dry eye. She suffers from red, painful, irritated eyes most of the day and can barely keep her eyes open. When we evaluated her, she had an extreme amount of corneal staining, which indicates severe dry eye.

Luckily, I do feel she is a great candidate for a scleral lens to help soothe and heal her eyes. Scleral lenses work really well for these types of patients. Scleral lenses will not cure dry eye, but it will help patients significantly with comfort and redness.

Due to the trabeculectomy in the left eye, the only option for her is something called the EyePrint Prosthetic. This is a very special type of scleral lens that is extremely custom to each patient. We take an impression of the ocular surface (kind of like an impression you'd take at a dental office). You can see the end result in the blue tray. Notice the upper area that looks like a hole - that is where her trabeculectomy is located.

Next, we will send the impression to the EyePrint lab. They will use special 3D scanning technology to create a perfectly fit device for her. After, they will ship it to us where we will insert it on the patient's eye.

sMap OS overall

Topo OS

The end result will hopefully be a comfortable scleral lens which alleviates much of her dry eye symptoms.

Thanks again to Dr. Amran for your kind referral! We will keep everyone updated on this case.

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