[Custom-Designed Scleral Lens Restores Vision in Combat Officer During the Iron Swords War: Telescopic for Distance...

This case report outlines the visual rehabilitation journey of a combat military officer who sustained a penetrating ocular injury caused by a metallic foreign body during active duty in Operation Iron Swords. Such injuries often lead to immediate anatomical disruption and vision loss, while also posing risks for later complications such as intraocular infection and hypotony. Upon presentation, the patient exhibited marked vision impairment, ocular pain, continuous irritation, and a sensation of a foreign object. Imaging studies identified a scleral rupture, retinal detachment involving macular injury, and the presence of a metallic object embedded in the retina. Emergency surgical management included scleral wound closure, removal of the crystalline lens, pars plana vitrectomy, extraction of the foreign object, and silicone oil tamponade. Despite successful anatomical repair, the patient's visual acuity remained at hand motion, with preserved peripheral fields and suboptimal eyelid appearance. Additional procedures and pharmacologic adjustments were required to manage secondary complications, including intraocular pressure elevation. As part of the rehabilitation strategy, a customized scleral contact lens was introduced, yielding significant functional improvements. Distance visual acuity reached 1.00 logMAR, and near vision improved to 0.70 logMAR. The lens also alleviated dry eye symptoms and contributed to improved cosmetic appearance. This case highlights the value of scleral contact lenses as an effective adjunct in the rehabilitation of complex ocular trauma. In addition to improving dry eye symptoms, ocular comfort, and improved ptosis, the fitted scleral lens functioned as an optical aid with telescopic properties, providing magnification for near tasks. It enabled the patient to make use of intact peripheral retinal zones beyond the damaged macula, thereby enhancing overall visual function despite the macular damage.