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Fluid filled scleral contact lens in pediatric patients: challenges and outcome

Varsha Madanlal Rathi1, Preeji S Mandathara, Pravin Krishna Vaddavalli

  • 1Cornea and Anterior Segment Services, L V Prasad Eye Institute, Banjara Hills, Hyderabad, AP, India. varsharathi@lvpei.org

Contact Lens & Anterior Eye : the Journal of the British Contact Lens Association
|March 31, 2012
PubMed

Insights

Fluid-filled scleral contact lenses (ScCL) are effective for pediatric patients with ocular surface disease (OSD) and irregular astigmatism. These lenses improve vision and maintain ocular health, though tear debris can impact visual acuity.

Area of Science:

  • Ophthalmology
  • Contact Lens Technology
  • Pediatric Eye Care

Background:

  • Scleral contact lenses (ScCL) offer therapeutic benefits for complex ocular conditions.
  • Fluid-filled ScCL are utilized to manage ocular surface disease (OSD) and irregular astigmatism.
  • Pediatric application of ScCL requires specific considerations for fitting and management.

Purpose of the Study:

  • To evaluate the indications for fitting fluid-filled scleral contact lenses (ScCL) in pediatric patients.
  • To identify challenges associated with fitting ScCL in this demographic.
  • To assess the impact of ScCL on visual acuity and ocular surface health in children.

Main Methods:

  • Retrospective chart review of pediatric patients (≤16 years) fitted with fluid-filled ScCL (PROSE).
  • Indications included keratoconus (KC), Stevens Johnson syndrome (SJS), radiation keratopathy, and vernal keratoconjunctivitis (VKC).
  • Visual acuity was measured before and after lens wear; complications and patient self-sufficiency were recorded.

Main Results:

  • Fluid-filled ScCL were dispensed to 15 pediatric patients (20 eyes) for various indications including SJS and KC.
  • Vision improved by ≥2 lines in 85% of eyes; however, 45% experienced a ≥2 line drop after 4 hours due to tear debris.
  • No major complications were reported, and patients demonstrated self-sufficiency in lens handling, with two instances of lens breakage.

Conclusions:

  • Fluid-filled ScCL are beneficial for pediatric patients with OSD and irregular astigmatism, including those with KC, SJS, or VKC.
  • These lenses contribute to maintaining ocular surface health and improving visual function in challenging pediatric cases.
  • While effective, tear debris management is a consideration for sustained visual acuity during lens wear.
Abstract

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