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Lupus patient with extreme dry eye

Thank you Dr. Mallinger for this kind referral.

We have 77 yo F with a h/o of lupus erythematosus and severe dry eyes was referred to us for a scleral lens consult. Her current regime for managing her dry eye symptoms included topical steroids, constant instillation of various artificial tears, and taping her eyelids at night when she sleeps. She has tried punctal plugs, ectropion repair, medicated dry eye drops and stem cell procedures with no improvement. She reports spending most of her time sitting in the dark with her eyes closed due to her severe discomfort and light sensitivity.

When we saw her, she was very light sensitive and was wearing sunglasses inside. She had 2+ inflammation and 4+ diffuse SPK OU. She had a lot of difficulty keeping her eyes open due to her discomfort and pain from the dryness. Her VA was 20/60 right eye and 20/200 left eye with no correction.

With all that she had been through, we felt that it was worth trying a scleral lens to protect her corneas from the outside environment and allow them to bask in continuous moisture to allow them to heal. We recommended the EyePrint Prothesthic due to her highly irregular corneal surface.

It was night and day after the first time we inserted her lenses. She was able to hold her eyes open and reported significant comfort compared to her naked eye. Unexpectedly, she was able to achieve 20/25 vision! Due to the severity of her condition when we assessed her, we plan on having her wear the lenses continuously with close monitoring for the next few weeks.

We will keep you posted