Acquiring Scleral Lenses

[JPiven]

follow up question on sclerals

Dear Rebecca

Thanks for that informative review. I am not very famlilar with 'sclerals' but was impressed that you said they may be considered for anyone with severe impairment as a result of dry eye. Can you please review for me what the downside would be, if any, of this treatment -- other than the cost, which I have heard is considerable. If cost is not a major issue might this treatment be helpful for anyone with moderate to severe dry eye ? Also, how effective could you expect it to be ? For example, could it conceivably eliminate symptoms altogether ?

Thanks very much. I look forward to your reply.

Joe

[Rebecca Petris]

Is there anyone here who knows where to get ahold of these for moderate dry eyes? My Opthalmologist said that I wasn't a candidate for them, but what does he know. My condition sounds very similiar to that of Philip fom Germany's and I would like to give them a try. Currently, the only place I know that fits them is the Boston Foundation for Sight, in Boston.(obviously) And they only fit them to people who have more advanced corneal diseases.

I think I would be kind of bummed out if my only option would be to fly to Great Britain to have a shot at them.

Montgumski,

Boston Foundation for Sight certainly has state-of-the-art equipment for this process (and they are constantly upgrading it - just acquired a new half-million dollar lathe/milling machine). Their process, and their mission, is pretty unique. There are also several practitioners in other parts of the US (Florida, Boston, Cleveland Clinic) as well as at Moorfields in London who fit some type of scleral lenses, so there are several options.

With respect to BFS and patient criteria, my understanding is that there are no absolute minimum clinical criteria that would rule someone out for a referral. I think that EITHER objective clinical findings OR patient-reported symptoms, if not both, suffice, on a case-by-case basis. One of their most dramatic success stories was a woman who had a high Schirmer, no staining, none of the usual signs of dry eye but basically could not open her eyes due to very extreme photophobia. I think that if your quality of life is greatly disrupted by dry eye, it's likely you would be at least given consideration as a candidate.

For what it's worth, here are my suggestions for you and anyone else who is considering sclerals but whose doctor says it's not appropriate for them:

1) Have you adequately communicated to your doctor the impact dry eye has had on your life? (If you're willing to go to Boston and go through this process, I'm guessing it is significant!) If you want a handy tool with which to do this, try OSDI, a scientifically validated survey which produces a score. (Eye doctors like numbers. )

2) Is your doctor fully aware of the wide range of conditions treated with sclerals? Perhaps you could ask the Foundation to contact your doctor if you think they may not be. Many doctors are under the impression that sclerals are exclusively for conditions like Stevens Johnson syndrome. Extreme cases are certainly those that will benefit the most, but that does not mean that milder cases cannot be considered for treatment. I just came back from exhibiting at a conference in California for ophthalmologists and spent quite a bit of time with the director of BFS who was visited in our booth by many doctors interested in sclerals, and I observed that many doctors simply were not informed of the range of cases treated with sclerals.

[Lucy]

Thread re: scleral lens

http://www.dryeyezone.com/talk/showt...t=Scleral+Lens



Above is a link to a fairly recent thread about scleral lens. It also has info about a practitioner in the Boston area who trained under the founder of the Boston Foundation for Sight.

[Montgumski]

Thanks for the response

Hi Lucy,

Currently, I live in Pennsylvania, so going to Boston would be ideal. But if I can find a good reputable doctor in Miami (or elsewhere)with experience fitting them that won't turn me away I might go that route.

Thx again

[Lucy]

Have you done a search on Scleral Lens Practitioners? I have the Boston Scleral Lens, which i (obviously) obtained from BFS.

I believe there are others who do fit scleral lens. I'm thinking of a doc in Fla and will post it here if I think of it. Where are you located? I doubt you'll have to fly to Britian to try these. Unless you just want to travel.

[Montgumski]

Is there anyone here who knows where to get ahold of these for moderate dry eyes? My Opthalmologist said that I wasn't a candidate for them, but what does he know. My condition sounds very similiar to that of Philip fom Germany's and I would like to give them a try. Currently, the only place I know that fits them is the Boston Foundation for Sight, in Boston.(obviously) And they only fit them to people who have more advanced corneal diseases.

I think I would be kind of bummed out if my only option would be to fly to Great Britain to have a shot at them.