Slit Lamp Findings in Scleral Lens Wearers With and Without Subjective Fogging
Jennifer Swingle Fogt1, Muriel Schornack, Cherie Nau
1The Ohio State University College of Optometry, Columbus OH, USA (J.S.F.); Mayo Clinic, Rochester, MN, USA (M.S., C.N.); Illinois College of Optometry, Chicago, IL, USA (J.S.H.); Forefront Eye Care, Boston MA, USA (A.N.); and University of Illinois at Chicago, Chicago, IL, USA (E.S.).
Eye & Contact Lens
|July 2, 2025
Summary
Midday fogging in scleral lens wearers is linked to front surface nonwetting and diffuse haze. These biomicroscopic findings, not lens fit, are associated with blurred vision during lens wear.
Area of Science:
- Ophthalmology
- Optometry
- Biomedical Optics
Background:
- Scleral lenses are advanced contact lenses used to correct complex vision problems.
- Midday fogging, a common complaint among scleral lens wearers, causes visual blur.
- The underlying causes of fogging require further investigation to improve patient outcomes.
Purpose of the Study:
- To investigate the relationship between scleral lens fit characteristics and biomicroscopic findings.
- To determine if these factors contribute to the subjective symptom of midday fogging in habitual wearers.
Main Methods:
- A prospective, observational study involving 48 habitual scleral lens wearers.
- Slit Lamp biomicroscopy assessed fluid reservoir depth, limbal clearance, edge fit, conjunctival prolapse, front surface wetting, and debris.
- Logistic regression analysis compared findings in eyes with and without reported fogging.
Main Results:
- 58% of participants reported experiencing midday fogging.
- No significant differences were found in scleral lens fitting characteristics between fogging and non-fogging eyes.
- Front surface nonwetting and diffuse haze in the fluid reservoir were significantly more prevalent in eyes with fogging.
Conclusions:
- Front surface nonwetting and diffuse haze are associated with patient-reported scleral lens fogging.
- These biomicroscopic findings, rather than lens fit characteristics, appear to be key contributors to midday fogging.
- Understanding these associations can guide clinical management and improve scleral lens wearer satisfaction.
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