Scleral Lenses – 5 Years Later

Not A Dry Eye BlogWe’re pleased to learn that after five years, PROSE lenses, a type of scleral lens fitted at Boston Foundation for Sight, are still helping about ¾ of the people who have them and who suffer with Dry Eye.

And we’re not surprised at the results of the review in which researchers confirmed that:

73.6% of patients were wearing the devices at five years. Patients with a distorted corneal surface were more likely to continue using the PROSE device than were those with ocular surface disease (84% vs. 64%, p=0.0121).

Ocular surface disease, a term sometimes used in place of Dry Eye, can manifest in many ways. About 80% of the time it is due to meibomian gland dysfunction (MGD). That’s why treating the meibomian glands, with probing or other interventions, is so important in the treatment of Dry Eye. This may also be why some people abandon scleral lenses, because the lenses aren’t treating an underlying condition that can cause extreme discomfort. Wearing the lens can even exacerbate discomfort in these cases.

Microbiome of Contact Lens Wearers Studied

Still 74% is significant. Though some of those patients may have other co-morbidities that still need to be treated e.g. the often missed conjunctivochalasis or SLK. For patients with these co-morbidities, scleral lenses may indeed provide relief from pain and discomfort (as long as they can tolerate something in their eyes) but without addressing the underlying cause of their pain.

Even though some patients are able to resume normal activities after being fitted with scleral lenses, a recent study discovered that the microbiomes of the eyes of contact lens wearers differ from the microbiomes of the eyes of those who don’t wear contact lenses. And an altered microbiome may increase the risk of eye infections in contact lens wearers. So to prevent infections, scleral lens wearers should practice good contact lens hygiene.


Changes in the eye microbiota associated with contact lens wearing
Shin H, Price K, Albert L, Dodick J, Park L, Dominguez-Bello MG.
2016 Mar 22;7(2). pii: e00198-16. doi: 10.1128/mBio.00198-16.
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Prosthetic replacement of the ocular surface ecosystem: impact at 5 years
J.S. Agranat, N.R. Kitos, D.S. Jacobs
British Journal of Ophthalmology
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