Scleral contact lenses for overnight wear in the management of ocular surface disorders.

PURPOSE

To describe the use of overnight wear scleral contact lenses (Scl CLs). The authors describe 7 patients using this modality of contact lens wear. Most of the lenses were made from highly gas-permeable materials, but a long-standing case is also reported when the lenses were made from PMMA, which is impermeable to gases.

BACKGROUND

There is a range of therapeutic indications for the use of Scl CLs. The development of rigid gas-permeable (RGP) materials has widened this range.

CASE REPORTS

Seven case reports are presented which describe patients in whom severe ocular surface disease has been managed with overnight-wear Scl CLs. The indications were: corneal exposure, post-radiotherapy complications, Stevens Johnson disease, recurrent erosion and congenital or post-surgical lid defects.

CONCLUSION

Scl CLs provide a therapeutic option for a range of complicated corneal and ocular surface conditions for which the treatment by other methods is either unsuitable or less effective. They have several advantages over silicone rubber and hydrogel lenses. The relative ease of handling for some patients allows removal for cleaning, their rigidity gives stability and a high degree of protection to the ocular surface, and the presence of a pre-corneal fluid reservoir optically neutralises an irregular corneal surface. Highly oxygen-permeable materials enable consideration of overnight wear in appropriate circumstances.