It happens nearly every day, someone asks me, “Dr. Sonsino, I hear more and more about scleral contact lens or complex contact lenses. What advantages do they offer over a regular soft or rigid contact?”
The answer: Quite a few advantages, for those who need and can wear them.
Like all contact lenses, scleral contact lenses and mini-scleral lenses help correct your vision defects. But unlike other contact lenses, scleral lenses also protect your eyes’ corneas, to achieve a therapeutic effect.
How do they do this? Scleral lenses “vault” over the sensitive cornea and rest on the less-sensitive sclera (the white part of your eye). So they are useful whenever your cornea may have been compromised. For example, damaged corneas, irregular corneas, and eyes with inadequate tear production (i.e., severe “dry eye”) may be dramatically helped by scleral lenses. That’s true because the scleral lens itself maintains a constant layer of soothing liquid up against your cornea. And that can have a healing and/or restorative effect on your eyes.

The Critical Need for SCI

So clearly there are tremendous benefits patients can enjoy from scleral or complex contact lenses.
But here’s the problem: Until now, there has been a serious deficiency in the training optometrists receive around these lenses. It truly takes a customized approach to fitting these lenses. And that’s the critical reason why Dr. Mile Brujic and I just launched the SCI … the Scleral Consultative Institute.
Dr. Brujic and I felt compelled to start the SCI—a forum to provide clinicians high-level training on all aspects of fitting scleral lenses—after seeing that many of our colleagues desire to fit complex lenses, but do not know how to implement the new technologies. Scleral lenses are daunting from a scientific, practical, and insurance-coding perspective. I have spoken to optometrists all over the country who lose money on every single scleral lens evaluation they offer. So Dr. Brujic and I understood that—if this situation were allowed to continue—there would be very few optometrists who can fit advanced contact lenses. And that would be an extremely negative situation for patients who might benefit from them.

Why SCI is “Navy Seal Training for Optometrists”

So we launched a “training mission”—a mission to train optometrists, so they could better serve their patients. We knew we wanted to offer the ultimate training for how to evaluate and fit scleral contacts lenses. And we thought long and hard about how to do it. In the past, I’ve presented many contact-lens-fitting workshops, but, in those workshops, I’ve generally only had time to teach how to put a contact lens on and off. But at SCI, the training is much more in-depth, hands-on, and intensive. And it lasts an entire weekend. A weekend designed to revolutionize the optometrist’s skill-level.
Here’s an overview of how it works: The participating optometrists are selected by leading eye care-related laboratories, who sponsor the weekend. The optometrists then fly in from all over the U.S., after which they listen to a didactic lecture illuminating the science behind the practice. They then work with each other to develop their skills. Finally—and very importantly—they work with actual patients, for whom they troubleshoot problems.
One extremely valuable part of the training is our teaching of how to properly code scleral lenses for insurance purposes. Getting insurance companies to cover this can be very tricky and, probably needless to say, insurance companies don’t tell optometrists how to do it. So we teach all the rules for dealing with insurance companies when a claim is filed on behalf of a patient.

One Skill-Transforming Weekend

The SCI weekend course is truly “soup to nuts.” It takes optometrists step-by-step through the entire process of fitting patients with scleral lenses, including all aspects critical to successfully implementing this into their practice. To make this high-value training affordable, Optique has teamed up with raw materials manufacturers of scleral lenses, to cover tuition for the optometrists. The optometrists only have to cover airfare and hotel expenses. Everything else, including meals, is covered. And all training is conveniently held at Optique’s specialty anterior segment practice in Nashville, Tennessee, located in the heart of Music City. Optique is equipped with all the most advanced technologies for evaluating contact lenses and advanced anterior segment disease.

A Ripple Effect That Benefits the Entire Country

The Mission Statement of SCI is something we passionately live to fulfill. It is:
[intense_blockquote]“To provide elite training in scleral lens evaluation, management, billing, and coding. This unique educational experience for the practitioner accelerates participants from little or no experience to complete competence over a weekend-long course in a state-of-the-art practice setting. Participants learn from didactic lectures, hands-on fitting, and troubleshooting with live patients with pathology.”
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Since evaluating advanced contact lenses constitutes the majority of Optique’s practice, we continually master the very latest developments and skills in the field. Hopefully, we will succeed in training our colleagues to have the level of success we see with our Optique patients. This will be good for the entire industry. When patients across the country have excellent outcomes, we know we will have accomplished our goal.

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.

More About Dr. Mile Bujik
Dr. Brujic, a member of the American Optometric Association and the American Academy of Optometry, is on the editorial board of numerous optometric publications. He has published more than 200 articles, and has delivered more than 1000 lectures, both nationally and internationally, on contemporary topics in eye care. He practices full-scope optometry with an emphasis on ocular disease management of the anterior segment, contact lenses, and glaucoma.

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