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Managing Complex Irregular Corneas with Scleral Contact Lenses Fernando Auza, O.D.  Visionary Ophthalmology Lecture Series 11 February 20, 2011
Scleral Lenses Beyond the Borders ,[object Object],[object Object],[object Object]
Terminology Alternative Names Diameter Bearing Tear Reservoir Corneal 8.0 to 12.5mm Cornea No Tear Reservoir Corneo-Scleral Corneal-Limbal Semi-Scleral Limbal 12.5 to 15.omm Cornea and Sclera Limited tear reservoir Full Sleral Haptic Miniscleral 15.0-18.0 Large Scleral 18.0 – 25.0 Sclera Tear reservoir directly related to size of haptic
Indications ,[object Object],[object Object],[object Object]
1. Vision Improvement – Main indication ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
2. Corneal Protection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
3. Cosmesis  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Scleral Lenses Vs Regular GP’s ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Scleral lenses and Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object]
Keratoconus. Contact lens or keratoplasty? Ophthalmology. 1988 Apr;95(4):487-92.  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Anterior Ocular Anatomy ,[object Object],[object Object],7.5mm 7.0mm 5.5mm 6.5mm
Limbal and Anterior Scleral Shape ,[object Object]
Limbal profiles ,[object Object],[object Object],[object Object],Daniel Meier/die Kontaktlinse
Limbal profiles ,[object Object],[object Object],Contact Lens Spectrum, June 2010
Limbal and Scleral Angles; the Scleral Shape Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Simmulated Scleral Topography based on the Scleral Shape Study
Scleral Lens Design ,[object Object],[object Object],[object Object],Contact Lens Spectrum; Dec. 2009
The Haptic/Landing Zone ,[object Object],[object Object],[object Object],[object Object]
Fitting Spherical Scleral Lenses – Four Step Approach ,[object Object],[object Object],[object Object],[object Object]
Chosing the Diameter ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Optical/Clearance Zone Diameter ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clearance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Evaluating corneal clearance ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Evaluating  Central Corneal Clearance 50microns 250microns 500microns
Evaluating peripheral corneal clearance ,[object Object],[object Object],Trace limbal touch Limbal clearance
Limbal Clearance ,[object Object],[object Object],[object Object],[object Object],[object Object]
Landing Zone Fit ,[object Object],[object Object],[object Object],[object Object]
Lens Edge Lift ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Conjunctival Impingement Courtesy of Cristine Sindt, OD, FAAO
Conjunctival Blanching
JC, 16y/o male presents for CEE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Soft Contact Lens Trial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Discussed Regular GP’s and Scleral Lenses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ID, 43y/o female presents for corneal evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LB, 28y/o female ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
[object Object],[object Object],[object Object],[object Object]
OD:Jupiter 15.6/7.18/-7.00 OR -17.00 20/30 453microns 300microns 6.5mm OS: 7.03/-8.00/15.6 OR -24.00  20/50
Ordered ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]

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Scleral lenses presentation final (1)