About the Book

The better understanding of the scleral contact lens dynamics on the ocular surface and the introduction of new diagnostic instruments to detect the ocular surface have permitted to better comprehend the ocular surface contour leading to the formulation of new scleral lens designs and techniques, increasing the fitting rate success. However, problems related to non-optimal fitting still occur, and some of them, in addition to problems due to handling, care, and compliance, have shown up, and they are unique to scleral lens wear. While issues related to scleral lenses wear are reversible, they affect patients’ satisfaction and lead them to discontinue scleral lens use. Some may be challenging, adding to the frustration, time, and costs for both practitioner and patient. 

Understanding the etiology of issues and complications is crucial for their management strategies that may vary depending on the type of problems that often may be managed in more ways or may require different changes. 

Troubleshooting problems is fundamental in scleral lens practice mainly because most of the time, the decision to use scleral lens represents a life-changing event for patients, and problems may result in eye surgery and/or depression or psychological problems and emotional instability. International associations provide continuous professional education to spread knowledge of scleral lens indications, their intrinsic advantages, and their troubleshooting. However, some practitioners remain intimidated by preconceived notions, the fitting process, and, especially, the ensue of problems and their management. As a consequence, clinicians rarely, if not at all, prescribe them. 

Describing in detail all the issues and complications that can ensue fitting scleral lenses will allow a better understanding of their origin and consequently, their resolution. Expansion of the use of these lenses depends on the increase of knowledge of scleral lens fitting and problem management, and patients will benefit from this knowledge expansion. Indeed, this is the objective of this manuscript.

Benefits to the Audience

Worldwide, scleral lenses are gaining popularity among practitioners and patients. When fitting scleral lenses, problems may ensue, and sometimes, practitioners are not able to correctly recognize the etiology, so to adequately manage them. In literature, many articles describe scleral lens complications and provide suggestions on their management. However, none of the reports explain the difference between issues and complications. Additionally, various issues related to a non-optimal fitting relationship, handling, care, and compliance are not reported all together, and currently, clinicians need to consult different references to understand how to manage the problems, and often, this creates confusion. Practitioners need a reference to consult for scleral lens problems, and they are in continuous research of a valid manuscript. 

This book discusses all issues and complications that may occur during scleral lens fitting and will provide guidelines on their management. This book is essential for every scleral lens practitioner. 

Key Features

1. Providing a definition and making a difference between issues and complications related to scleral lens wear and describing all of the issues and complications that can ensue from fitting scleral lenses. 
2. A schematic exposure of issues and complications has been preferred to make these chapters easily consulted during daily practice. 

Tables for a quick find index that capture all issues and complications, their symptoms, clinical signs, etiology, management, and observation are included in the manuscript. 

View the table of contents and chapter summaries here.