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Scleral Lenses in the Management of Corneal Irregularity and Ocular Surface Disease

Shorter, Ellen, O.D.; Harthan, Jennifer, O.D.; Nau, Cherie B., O.D.; Nau, Amy, O.D.; Barr, Joseph T., O.D.; Hodge, David O., M.S.; Schornack, Muriel M., O.D.

doi: 10.1097/ICL.0000000000000436
Article

Purpose: To describe current practice patterns regarding the use of scleral lens therapy in the management of corneal irregularity and ocular surface disease among eye care providers who fit scleral lenses.

Methods: The Scleral Lenses in Current Ophthalmic Practice: an Evaluation (SCOPE) study group conducted an electronic survey of eye care providers from January 15 to March 31, 2015. Respondents ranked management options for corneal irregularity in the order in which they would generally consider their use. Respondents also ranked options for the management of ocular surface disease in the order in which they would use each of the treatments. Results for each option were analyzed as percentage first-place ranking; percentage first-, second-, or third-place ranking; and mean rank score.

Results: Survey responses were obtained from 723 providers who had fit 5 or more scleral lenses. Of these respondents, 629 ranked options for management of corneal irregularity and 612 ranked options for management of ocular surface disease. Corneal rigid gas-permeable lenses were the first option for management of corneal irregularity for 44% of respondents, and scleral lenses were the first option for 34% of respondents. Lubricant drops were the first therapeutic recommendation for ocular surface disease for 84% of respondents, and scleral lenses were ranked first by 6% of respondents.

Conclusion: Scleral lenses rank second only to corneal rigid gas-permeable lenses for management of corneal irregularity. Scleral lenses are generally considered after other medical intervention and before surgery for the management of ocular surface disease.

Department of Ophthalmology, University of Illinois at Chicago (E.S.), Chicago, IL; Illinois College of Optometry (J.H.), Chicago, IL; Department of Ophthalmology (C.B.N., M.M.S.), Mayo Clinic, Rochester, MN; Korb and Associates (A.N.), Boston, MA; The Ohio State University (J.T.B.), Columbus, OH; and Biostatistics Unit (D.O.H.), Mayo Clinic, Jacksonville, FL.

Address correspondence to Muriel M. Schornack, O.D., Department of Ophthalmology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; e-mail: schornack.muriel@mayo.edu

The authors have no funding or conflicts of interest to disclose.

J. Harthan: consulting contracts: Allergan, Bausch + Lomb/Valeant, and Metro Optics and J. T. Barr: consulting contracts: Alcon, Allergan, Bausch + Lomb/Valeant Pharmaceuticals, and NovaBay. Contract research: Innovega and Valeant Pharmaceuticals; M. M. Schornack: advisor: Bausch + Lomb/Valeant. The remaining authors have no conflicts of interest to disclose.

This work was funded by an unrestricted grant to the Mayo Clinic Department of Ophthalmology from Research to Prevent Blindness and by the Mayo Foundation.

Presented in part as a poster at the Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO), May 1–5, 2016, Seattle, WA.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.eyeandcontactlensjournal.com).

Accepted August 14, 2017

© 2018 Contact Lens Association of Ophthalmologists, Inc.