The treatment of cornea pathology using scleral lenses

Abstract

This review focuses on the therapeutic use of scleral lenses in the treatment of corneal pathology described in the international scientific literature. The potential of scleral lenses in the treatment of pathology of the cornea and anterior segment of the eye has been studied since the late 1980s. The scleral lenses were actively used both in the treatment of corneal pathology and in the treatment of diseases of the anterior segment of the eye. The use of scleral lenses in the treatment of corneal pathology may promise an area for development for this treatment modality. Contrary to eye-drops, which remain on the ocular surface for a relatively short time, the scleral lenses provide a long-term hydration of the corneal epithelium and paralimbal conjunctiva. Tarsorrhaphy and other surgical interventions limit visual acuity and the field of vision and provide poor cosmetic results. The scleral lenses, however, can provide 2-in-1 therapy as they protect the ocular surface and, in case of epithelial roughness, may improve visual acuity in patients with ocular surface diseases. The ability of scleral lenses to provide a continuous hydration and protection of the ocular surface, allowing patients to maintain functional visual acuity, as well as their ability to be used in combination with other forms of therapy, makes them a valuable option for the treatment of severe ocular surface diseases. Incorporating scleral lenses into a combined, multidisciplinary approach to treatment can bring relief to patients without resorting to more invasive treatment options. Our analysis identified only a few studies on the use of scleral lenses in the treatment of corneal pathology, which is likely due to the complexity of customization of their fit. This indicates the need for scientific research aimed at developing universal scleral lenses for the treatment of the cornea based on the criteria of the radius of curvature and the diameter of the cornea of a healthy eye.