Learn more about Scleral Lens' Fitting issues and Complications with Dr. Caity Morrison

It’s time for Woo’s Wisdom! We learned a ton from Dr. Caitlin Morrison’s presentation, titled “Scleral Lenses: Managing Common Fitting Issues and Complications”. Here are some of the key takeaways:

· Lens dropping is one of the most common fit complications seen when fitting scleral lenses.

o Lens dropping can present with superior nasal touch, blanching beneath the inferior lens edge, conjunctival bogging inferiorly, and possible increased fogging

o Lens dropping commonly occurs when there is too much central clearance, if the edges are too loose, or if the lens is too tight.

o To differentiate what the cause is, center the lens by pushing the lens up with your finger on the patient’s lower eyelid. Evaluate the central clearance and edge alignment and adjust accordingly.

· Another common fit complication is conjunctival redness.

o For conjunctival redness, potential causes can be edges that are too tight resulting in impingement of blood vessels or digging into the conjunctiva, from conjunctival congestion, from suction forces, or conjuctivochalasis.

· The last common fit issue discussed was mid-day fogging. Mid-day fogging is typically secondary to a build up of leukocytes, lipids, and proteins beneath the lens. To address this, treat the patients ocular surface disease, decrease clearance as much as possible, use Nutrifill and/or more viscous artificial tears for filling solutions, and make sure to align edges as closely to the scleral curvature as possible.

Dr. Morrisons two pro tips were to ALWAYS use a fit set with toric PCs and not be afraid of making bigger adjustments to the edges. A meaningful change can be anywhere from 50 to 90 um depending on the design.

Be sure to watch her full presentation on WooU.org under past events!