and Post-Surgical Vision Restoration
If you have specialized vision requirements, such as wanting contacts with your reading prescription built in, if you have a more complex spectacle prescription, or a corneal dystrophy such as keratoconus, you may require customized contact lenses.
For clarity, a “specialty contact lens,” is any contact lens that falls outside the parameters of a standard “off the rack” soft contact lens.
What is a Large Diameter/Semiscleral Specialty Lens (SSL) and what is so special about these contact lenses?
Semiscleral lenses rest on the sclera, a robust and less sensitive white tissue on the surface of the eye. In contrast, regular contact lenses rest on the cornea, a very delicate thin membrane responsible for providing optical quality to the image that focuses on the retina.
Semiscleral Specialty Lenses are highly permeable (breathable) lenses and an optimal vision correction option for irregular (distorted) corneas. These lenses are designed to rest on the more resilient and insensitive part of the eye surface, a white tissue called sclera. These specialty lenses vault over the whole cornea creating a protective interface in between the lens and the cornea that is filled with tears.
These lenses are state of the art devices, custom-designed for the particular cornea, fitting the unique features of the individual eye.
The concept of optically neutralizing the cornea with an enclosed liquid reservoir over its front surface was first proposed in 1508 by Leonardo da Vinci (1).
The surface of the cornea is the most sensitive tissue of the human body and the eye’s most important focusing lens is immersed in this “liquid bandage”. The fluid reservoir acts as a healing chamber that relieves the pain and light sensitivity of eyes that are severely dry or suffer from chronic corneal inflammation, and nurtures the healing of corneal erosions and ulcers that failed to respond to conventional treatments.
A Second principal benefit of the fluid reservoir is its ability to mask irregularities of the corneal surface to improve vision. In many cases, it works miracles for certain patients that could not find any help with other alternatives.
Who is a good candidate for this modality of specialty contact lenses?
There are hundreds of thousands of people in the United States, and many more all over the world, that suffer corneal conditions causing severe vision loss that could benefit from this specialty lens modality. In addition, individuals with serious dry eye related problems profit from these lenses.
Many of our patients did not even know about this option until they came to see Dr. Arroyo. Only a handful of doctors have the expertise to fit these lenses. The most exciting fact is that these specialty semi-scleral lens design may delay or even replace all together the need for a corneal transplant surgery which may cause serious complications, an uncertain visual outcome and many time long recovery periods. With semi-scleral lenses, properly fitted, the solution is non-invasive and very rewarding.
Even patients that already underwent corneal transplant surgery can be extremely successful in vision recovery, as the cornea gets distorted during the healing process.
Dr. Arroyo has lectured and trained American doctors and eye care specialists from other countries in related subjects such as hyperopic and multifocal corneal molding, a modality that allows patients to be glasses/lenses free during waking hours.
Semiscleral lenses are usually very comfortable, thus very valuable when traditional rigid gas-permeable contact lenses are not well tolerated.
Semiscleral or large diameter specialty lenses are a great choice for patients with conditions such as keratoconus and other corneal degenerations, following corneal surgery such as transplants, laser procedures and injuries.
In addition, patients with excruciating conditions, agonizing pain and extreme light sensitivity find these lenses miraculous in mitigating the pain better than any other option. Such conditions include Stevens-Johnson syndrome, Sjogren’s syndrome, large recurrent corneal erosions, etc.
In summary, Semiscleral Specialty Lenses open up a new level of care in the treatment of challenging optical and medical eye surface conditions in a safe, non-surgical fashion
A partial list of patients who benefit from these lenses are those who suffer from:
Irregular corneas and irregular astigmatism from numerous etiologies
Pellucid Marginal Degeneration
Refractive surgery complications (RK, PRK, LASIK. LASEK…)
Dry Eye Syndrome
Graft –Vs.- Host disease
Ocular Cicitricial Pemphigoid
Poor lid closure causing ocular desiccation
Many other etiologies