Interview with Dr. Elise Kramer
Dr. Elise Kramer, from Miami Contact Lens Institute, is a residency-trained optometrist in Miami, who specializes in ocular health and disease, ocular surface disease and regular and specialty contact lens fitting.
Among the latter, she designs and fits scleral lenses. This is the topic we have chosen to speak about with Dr.Kramer.
Dr. Kramer, what are scleral lenses?
Scleral lenses are larger than regular contact lenses that are used to restore the ocular surface in conditions that do not respond to other treatments and in people who cannot obtain good vision and comfort with glasses or conventional contact lenses. These lenses are custom made for each patient and are fitted in a way to vault the cornea and maintain a constant reservoir of fluid between the lens and the cornea to ensure that it remains hydrated. More over, this fluid layer also compensates for the surface irregularities, leading to improved vision. Our scleral lenses are highly permeable to oxygen and provide the comfort of a soft lens with higher optical quality. Most patients will have no sensation or awareness of the lens while wearing it.
For whom are they intended?
These lenses are designed to restore the quality vision and ocular comfort to those patients who have been affected by keratoconus, refractive surgical complications, corneal transplant surgery, ocular trauma, chronic dry eyes, corneal dystrophies and degenerations and a host of other ocular conditions and diseases. They can also be used in patients who have a completely normal ocular surface but are looking for a superior level of vision and/or comfort.
Which conditions do you treat with these special lenses?
Examples of conditions treated with scleral lenses are: dry Eye Syndrome, chemical and burn injuries, keratoconus and ectasia, corneal degenerations and dystrophies, eyelid abnormalities, stevens Johnson Syndrome, sjogren’s Syndrome,corneal ectasia and other complications from LASIK, post-corneal transplant, radial Keratotomy (RK).
But as I said previously, they can also be used in patients who have a completely normal ocular surface but are looking for a superior level of vision and/or comfort.
What are the main benefits of wearing scleral lenses?
Scleral lens designs currently available are considered the best option on the market to provide health benefits and increased comfort. These lenses eliminate blurred and distorted vision, promote healing of the ocular surface and protect the cornea from the surrounding environment and eyelids.
How they should be inserted and removed?
The application and removal of your scleral contact lenses can seem intimidating at first. But if you follow my instructional video on the website www.eye-clarity.com/scleral, the process can be quite simple.
Could they be replaced with other lenses?
A gas permeable contact lens will not be able to address the many problems threatening a compromised cornea. Most of the altered corneas that we see at Miami Contact Lens Institute are very distorted or dry and irritated. A conventional gas permeable contact lens will have to rest on the compromised cornea. If the cornea is irregular or irriated due to LASIK surgery, corneal transplant surgery, trauma, disease or from keratoconus, this type of lens will only make matters worse because it is in direct contact with the cornea. This is also true for a hybrid lens as this lens also will have contact with the compromised cornea. The scleral lens is unique in that it can provide relief from pain and discomfort while simultaneously providing excellent vision and promote healing to the altered cornea.
For how long could one use the same pair of lenses?
2-3 years based on how well the patient maintains them!
So, would you recommend scleral lenses?
Absolutely! Scleral lenses have allowed tens of thousands of patients who have suffered vision loss due to keratoconus, post-refractive surgical complications, severe dry eyes and many other ocular surface conditions see clearly and comfortably once again.