In the real world of optometry, there are two ways to evaluate your eyes for scleral contact lens evaluation: The way many optometrists do it, and the right way. At Optique, we believe it crucial to be at the vanguard of offering this service the right way.

Unfortunately, when most optometrists in 2017 evaluate your eyes for scleral contact lenses, they do so using techniques that are—to put it politely—out-of-date. Using a type of dye, they place that dye between your eye and the scleral lens. They then see how the dye pools, in order to fit your lens.

For years, that was considered THE BEST way to evaluate eye/lens needs. But any optometrist using that method today may be doing so for a few simple reasons: They either don’t have enough experience with specialty contact lenses, dabbling in them on a few cases; or they haven’t invested in the latest technology. That latest technology, as we’ll see in a moment, permits much greater precision during an evaluation.

OCT Scanning: How Your Eyes Benefit

Here at Optique, we believe it is vital to evaluate and prescribe hybrid and scleral contact lenses on the most advanced level possible. Rather than engage in yesterday’s techniques, we utilize Optical Coherence Tomography (OCT) scanning, today’s most sophisticated tool for assessing eye health, managing eye conditions, and evaluating your eyes’ precise needs with respect to (among other things) scleral contact lenses. OCT is a non-invasive, highly sophisticated scanning system that produces stunningly detailed images of your eyes. Think of it as a sort of “MRI or x-ray of the eye,” but without the radiation. Using a digital caliper, OCT measures the EXACT vault of the lens above the surface of the eye, so we can tell EXACTLY the amount of vault at ANY point under the contact lens. The word “vault” is used to convey that scleral contact lenses are fit to “vault” over the cornea and rest on the sclera, enabling the contact lenses to hold a fluid reservoir. By using the images and information gleaned from an OCT scan of your eye, we can fit your scleral contact lens to the precise contours of your cornea.

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My Article in Contact Lens Spectrum

I am so excited about this technology that I recently wrote an article entitled “Using OCT for Evaluating Complex Contact Lenses,” which was published in Contact Lens Spectrum, an industry journal. In the following article passages, I offered some background on OCT technology:

“OCT was once reserved for use in the retina. OCT uses near infrared light passed through the clear structures of the eye to generate a cross-sectional image of the layers of the retina, much like an image generated by magnetic resonance imaging. Advances in OCT technology have improved the resolution to image the eye down to the micrometer (one one-thousandth of a millimeter) scale.

“OCT technology is now commercially available not only for the retina, but for the anterior segment as well. The obvious application is to help practitioners with fitting and evaluating complex contact lenses that vault the cornea . . . .

“Anterior segment OCT (AS-OCT) allows practitioners to view a cross-sectional image of a contact lens on the eye in real time and to monitor the health of the cornea in the presence of the contact lens. This view is valuable for judging the vault of new contact lens designs over the cornea and for judging where the lenses land on the eye. It is the most specific way to determine whether the lens fit is acceptable and to troubleshoot when the lenses are not fitting appropriately.”

What This Means for You and Your Eyes

Why is this dramatically greater evaluation precision so crucial? And why should it matter to you?

Here’s why: The very latest research reveals that the precise fit of a contact lens is incredibly important to the maintenance of a healthy cornea, and for your over-all eye health. As I wrote in the article, “These newer lens designs are intended to vault over the central cornea, and do not contact the central cornea at all. Such contact lenses have resulted in much more comfortable and wearable strategies for full-time use.”

Without that precise measurement—which enables us to give you the precise scleral contact lenses you need—the cornea will experience swelling.

Why does that matter? Because the cornea is your eye’s protective outer layer. Along with the sclera (the white of your eye), it serves as a barrier against germs, dust, dirt, and other elements that can cause damage to your eyesight. Your eye’s cornea also helps to filter out some of the sun’s harmful ultraviolet light.

The cornea also plays a key role in vision. As light enters your eye, it gets refracted (bent) by the cornea’s curved surface. This helps determine how well your eye can focus on far or near objects.

If your cornea experiences swelling, that is a sign that it is under stress.  A cornea under stress is more prone to infections, scarring, new and harmful blood-vessel growth, and a host of other problems.  Noticing that there is swelling is the first step.  Knowing how to fix it is the most important factor in your long-term success at wearing scleral lenses.

And that’s why proper contact lens evaluation and fit is so crucial. An optometrist friend of mine recently published an article that revealed that even expert optometrists using older methodologies to judge the fit of scleral lenses misjudge the vault of a lens by up to 75 percent. Missing by that much may have been acceptable when optometrists were limited in their evaluation tools. But it certainly no longer is. Not remotely.

Optique Stays Systematically at the Forefront of Technology

At Optique we have made—and continually live—a commitment to remain at the absolute vanguard of technology. In fact, we believe in this so strongly that we work with medical and eyecare manufacturers themselves to achieve continual improvements. Numerous companies send us their new software and equipment, before it hits the market, to solicit our feedback and keep us abreast of innovations.

Remember: All this about contact lenses, corneas, and OCT technology may seem complex, but it all boils down to a simple idea: With more precision comes better outcomes. And those better outcomes are what we always want you to experience.

More About Dr. Jeffrey Sonsino

Dr. Sonsino is a diplomate in the Cornea, Contact Lenses, and Refractive Technologies section of the American Academy of Optometry (AAO). He is also chairman of the American Optometric Association’s (AOA) Council on Cornea and Contact Lenses, a fellow of the Scleral Lens Education Society, and is on the advisory board of the GPLI. He is a consultant or advisor to Alcon, Optovue, SynergEyes, and Visionary Optics and recently was awarded the Practitioner of the Year by the GPLI.

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