VIDEO: Pupil measurement important when fitting scleral lenses

Chang C, et al. New residual HOA-correcting scleral lens in a post-iLink patient. Presented at: Optometry’s Meeting; June 21-24, 2023; Washington.

Chang C, et al. New residual HOA-correcting scleral lens in a post-iLink patient. Presented at: Optometry’s Meeting; June 21-24, 2023; Washington.

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WASHINGTON – In this Healio video perspective, Clark Chang, OD, discusses a case report he presented at Optometry’s Meeting that illustrates the importance of pupil measurement when fitting scleral lenses.

Chang, director of specialty contact lenses in the cornea service at Wills Eye Hospital and director of medical affairs for Glaukos, said his patient complained about visual disruptions at night after trying other lenses, including a scleral contact lens, after undergoing corneal cross-linking in the left eye.

“The hiccup throughout the process is that he also happens to have quite a large pupil,” Chang said. “I measured up to 8 mm and possibly even larger, and that meant that we had to alter the fitting design in the base lens with a larger [optical zone], so we could proportionally increase the optical zone of the [higher-order aberration] optics.”

The patient reported that his symptoms resolved throughout the day and night after starting to use the new lens.

“Pupil measurement is important, even if you are not considering higher-order aberration correction, because the scleral lens tends to decenter,” Chang said. “If it decenters even 1 mm, that effect is double on the [optical zone] in terms of the radius.”