Scleral Lenses Identified as a First-Line Treatment For Corneal Irregularity

Eye care professionals consider scleral lenses (SLs) to be the first treatment of choice for managing corneal irregularities, according to data reported in Eye & Contact Lens. This treatment option, however, ranks below lubricants, topical agents, and punctal plugs for managing ocular surface disease, the report shows. 

Researchers included electronic survey data from 778 eye care professionals (researchers, Scleral Lens Education Society members, international specialty contact lens meeting attendees) between November 8, 2019 and March 31, 2020 in the analysis. Participants completed the survey by ranking treatment options for corneal irregularity and ocular surface disease in the order they would use them.

The survey respondents ranked SLs as the first choice for managing corneal irregularity (42%), followed by corneal rigid lenses (20%). However, less than 1% of study participants ranked SLs as the first-line treatment for ocular surface disease. Over-the-counter lubricant drops, meibomian gland expression, topical cyclosporine or lifitegrast, topical steroids, and punctal occlusion were reported as more appropriate treatments, and 45% of the study participants ranked SLs as the sixth, seventh, or eighth best management strategy. 

“In this study, SLs emerge as the first-choice option for the management of corneal irregularity among practitioners that prescribe SLs,” according to the study authors. “Scleral lenses remain a lower-tier therapeutic option for ocular surface disease, and are placed after use of lubricants, meibomian gland expression, punctal occlusion, and topical medical therapy, but before surgical intervention. This information allows individual practitioners to compare their practice patterns with those within the international SL community.”

Study limitations include failure to distribute the survey across various levels of subspecialties and failure to differentiate between different levels of disease severity.