The Dual Benefits Of Scleral Contact Lenses In Keratoconus: Visual Improvement And Trauma Protection

A case showing both the visual rehabilitation and protective effects of scleral contact lens use will be discussed.

A 29 year-old male patient who was followed up for stage 3 keratoconus in his right and left eyes according to the Amsler-Krumeich classification. The patient was using scleral contact lenses and was working in the automotive sector.The patient's corrected visual acuity is 1.00 logMAR in the right eye and 1.30 logMAR in the left eye. After the application of scleral contact lenses, the corrected visual acuity increased to 0.05 logMAR in the right eye and 0.15 logMAR in the left eye. 

4 months after the follow-up, the patient applied to the emergency clinic with a complaint of a foreign body impact in his right eye. In his anamnesis, he stated that the lens attached to his eye had shattered during the foreign body impact and he brought the shattered lens with him.

A full ophthalmological examination was performed, including autorefkeratometer measurements, anterior segment examination with a biomicroscope and posterior segment examination with a +90D lens.

In the ophthalmologic examination, the anterior segment was normal except for a mild conjunctival hyperemia after the trauma, and no cells or reactions were observed in the anterior chamber. No floaters, tears, or detachments were observed in the posterior segment structures. Corrected visual acuities persisted at 1.00 LogMAR in the right eye and 1.30 LogMAR in the left eye. The patient's scleral lens was shattered as a result of a metal burr impact in his right eye, but no abrasions occurred in the cornea and sclera.

The vast majority of keratoconus patients are young adults and a significant number of these patients work in sectors that pose risks in terms of occupational safety. This case supports the idea that scleral contact lenses not only provide visual rehabilitation in keratoconus patients but also act as a protective barrier against mechanical trauma.