We have witnessed a rise in clinical utilization of scleral lenses in recent years, and in some cases, their clinical indications have expanded to include even those patients with regular corneas. Given this sharp rise in scleral lens utilization, the principle of lens selection continuum as proposed by Visser et al appears to also hold true in patients with normal healthy eyes. Thus, when should clinicians reach for scleral lenses when providing care to patients with regular corneas?
Best practice guidelines are just that—guidelines. They’re not religious dogma designed to herd everyone into the same line. We are rightly moving toward more evidence-based medicine, such as increased use of bandage lenses and less pressure patching in the management of corneal abrasions and erosions.
Ben Gaddie, OD, FAAO, Optometry Times Editorial Advisory Board member, noted several specific areas that were advancing to give ODs better data and better control over patient health outcomes, including:
• Corneal mechanics
• 24-hour IOP monitoring
• New glaucoma drugs and drug delivery systems
• Advancements in OCT imaging