Eye Injuries and GVR Scleral Lens

The Healing Power of the Scleral Lens

The two photos below are of the left eye of a patient who suffered significant trauma to his body, face and left eye in a car accident. This patient’s upper left eyelid was severed from flying glass. His left cornea had numerous particles of glass which nearly perforated his cornea, but did create a purulent corneal ulceration. Two months ago reconstructive surgery was performed on this patient’s left upper eyelid. One month ago I fit this eye with a scleral lens to protect it from the environment and the blinking action of the eyelid. 7 days ago I refit this eye with a very thin gas permeable scleral lens made with a highly oxygen permeable material that is FDA approved for wear during sleep. Because this patient is unable to close his left eye completely, I asked him to wear this lens during sleeping hours as well as during the his waking hours. He has been wearing this lens all day while taking short breaks during the day to remove the lens, rinsing out his eye with saline solution, cleaning the lens and reinserting it. Look carefully at the photos below. The first photo was taken one month ago when I first met this patient and placed a scleral lens on this eye. Note the inflammation, mucous formations and the opaque, cloudy cornea. At the initial visit, this patient’s best corrected visual acuity was finger counting. The 2nd photo was taken yesterday. Note how much clearer his cornea is. In the 2nd photo you can see his pupil which is barely visible in the first photo. Also note the improved appearance of his upper eyelid in the 2nd photo. With this very thin highly oxygen permeable scleral lens, this patient’s corrected visual acuity is now 20/150. The oculoplastic surgeon who I share this patient with was as surprised as i was at the degree of improvement in such as short period of time. Three months before I met this patient, he was told by a very prominent eye specialist that this eye needed to be removed. Fortunately he and his family decided to obtain another opinion. This patient’s story, his eye and his scleral lens “journey” with me has to be one of the most unforgettable experiences of my career.

Eye Print Pro Treats Highly Irregular Eye, From 20/800 to 20/20

The photo below is of an Eye Print Pro Scleral lens on an eye that suffered 2 separate retinal detachments within a 4 month period requiring 2 separate vitrectomy surgeries (surgeries to remove the interior "gel" within the eye known as the vitreous and replacing it with saline). In addition, cataract surgery was done after the first vitrectomy. Several months later, the intra-ocular lens dislodged into the posterior chamber of this eye requiring emergency surgery. For this reason, a 2nd vitrectomy was done along with a retinal surgical repair procedure known as a scleral buckle. Eye Print Pro Scleral lens technology allows us to make a lens from an impression of the front surface of the eye. A very gentle impression material known as Polyvinyl Siloxane is placed on a plastic holder which is then placed on the front surface of the eye and under the eye lids. After a few minutes, the plastic holder with the eye mold is removed and sent to our laboratory where a scleral lens matching the exact contour of the cornea and the white portion of the eye is made. This technology is designed to help patients whose ocular surfaces have been extremely altered due to disease and surgery see clearly once again. In the case of the eye shown in this photo, without the Eye Print Pro, the vision in this eye is less than 20/800. With the Eye Print Pro lens this eye is corrected to 20/20 vision without any distortions. The 2nd photo shows how the impression material appears on the eye. The procedure is fast and painless.

Cataract and Vitrectomy due to Penetrating Injury

This little girl and her family visited us from Argentina. Last year she suffered a penetrating ocular injury to her left eye which resulted in a torn perforated cornea and significant damage to the internal ocular structures within this eye. She underwent cataract and vitrectomy surgeries in her left eye and in addition retinal surgery for a retinal detachment. Repair of the torn cornea required significant suturing. When she entered our office for the first time the visual acuity in her damaged eye was hand motion at just a few inches from her eye. Because of the irregular cornea and exposed sutures on the corneal surface, we are fitting this little girl with a GVR Scleral lens. It is our hope that this lens will protect the healing cornea and neutralize the visual effect of the distorted cornea. In the near term, we expect this lens to improve her visual acuity to about 20/600 or better and in addition to provide her with some peripheral vision. In the lower left photo you can see the scleral lens over the traumatized cornea. In the lower right photo you can see the scar tissue along with the corneal sutures holding the cornea together. Many months (and possibly years) of exams, office visits and lens changes will need to be done before we can know the final vision her left eye will be capable of.

Pseudomonas Keratitis Infection from Pool Leads to Corneal Scar. Now 20/25 with GVR Scleral Lens

In 2004, this patient developed in his left eye a relatively rare eye infection known as Pseudomonas Keratitis. This infection is caused by an organism found in lakes, soiled water and unclean swimming pools. This patient feels that got this infection from swimming in a pool. Several weeks after he became infected he developed a red eye along with a corneal ulcer. He visited several eye doctors who eventually were able to subdue the infection. The result, however, was a deep scar in the center of his cornea which needed to be treated with a laser in order reduce it's intensity. 4 months after the laser treatment this patient was referred to our office. The corneal scar left his cornea with a very irregular surface. His best corrected vision in his left eye was less than 20/200. Eyeglasses and contact lenses were unable to correct his vision. In early 2005 we fit this patient's left eye with a GVR Scleral lens which allowed him to see clearly (20/25) and comfortably once again. Over the last 10 years we have seen this patient on a yearly basis. His vision has remained stable and his eye has remained healthy.

20/400 with Glasses Due to Corneal Ulcer, now 20/30 with GVR Scleral Lens

About 12 years ago this young man wore his soft lenses for an extended period of time without removal while he was away from home at sleep-away camp. When soft lenses are worn without removal for an extended period of time and without being cleaned and disinfected, the bacteria count within the lens will build and toxins from the bacteria will "eat away" at the cornea. What resulted was a devastating corneal ulcer in his right eye which scarred and severely distorted his cornea. For over 4 years, this young man had very little vision in his right eye, in fact he was legally blind with best corrected vision of 20/400 with eyeglasses. 8 years ago we fit this patient's right eye with a GVR Scleral lens. With this lens he can see 20/30 in his right eye without any distortions and all day wear with excellent comfort. If it were not for this type of lens technology, this young man would have had to have a corneal transplant.

SMAP 3D Scleral Lens Design

Last year we introduced an exciting piece of technology that has allowed us to custom design a scleral lens much more accurately. It is the SMAP 3D, which is a computer attached to a dedicated camera that allows us to obtain a 3 dimensional image of the entire front surface of the eye, including the cornea and the surrounding white portion of the eye (the sclera). Up until now there has not been any technology that would allow us to measure the ocular curvatures outside the cornea. The SMAP allows us to do this. Read More

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EyePrint Pro

EyePrintPro technology creates a scleral lens based on a mold of the cornea. The molding is accurate to 1 or 2 microns and fits perfectly because it exactly mirrors the irregularities of the individual corneal surface. The technology is well suited for post-Lasik, Keratoconus, RK, eye injury, and corneal transplant patients. Read More in this PDF about EyePrintPro Scleral Lens Technology

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