Visual Rehabilitation With a Scleral Lens in an Eye With Corneal Scarring
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By
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Maddison Fortman, OD
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September 17, 2026
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4 min
Clinical Report: Visual Rehabilitation With a Scleral Lens in Corneal Scarring
Overview
This case report details the successful use of a scleral lens for visual rehabilitation in a patient with corneal scarring due to a post-cross-linking ulcer. Topical losartan was incorporated within the lens reservoir.
Background
Scleral lenses are increasingly utilized for visual rehabilitation in patients with corneal scarring resulting from various causes, including disease and trauma. Their ability to enhance visual acuity and facilitate sustained ocular drug delivery makes them a valuable option in managing complex ocular conditions.
Data Highlights
| Time Point | Best-Corrected Visual Acuity (BCVA) |
|---|---|
| Initial Fitting | Hand Motion |
| 1 Month | 20/25-2 |
| 3 Months | 20/20 |
Key Findings
- A scleral lens improved visual acuity from hand motion to 20/20 over a period of 3 months.
- Topical losartan was administered at a concentration of 0.8 mg/ml, 4 times daily, to reduce corneal scarring density.
- The scleral lens design included three SmartChannels to enhance tear exchange and reduce suction.
- Topical losartan is an off-label treatment for corneal scarring and is not FDA approved for this indication.
- Animal studies have shown that topical losartan can reduce corneal opacity following injury.
Clinical Implications
The use of scleral lenses in patients with corneal scarring can enhance visual acuity while also serving as a delivery system for topical medications.
Conclusion
This case highlights the role of scleral lenses in visual rehabilitation and drug delivery.
Related Resources & Content
- Dutra BAL, Wilson SE, J Ocul Pharmacol Ther, 2025 -- Topical losartan in the management of corneal scarring fibrosis: update on dosage, efficacy, and potential epithelial toxicity
- Rodgers EG, Al-Mohtaseb Z, Chen AJ, Cornea, 2024 -- Topical losartan for treating corneal haze after ultraviolet-A/riboflavin collagen cross-linking
- Sampaio LP, Hilgert GSL, Shiju TM, Santhiago MR, Wilson SE, J Refract Surg, 2022 -- Losartan inhibition of myofibroblast generation and late haze (scarring fibrosis) after PRK in rabbits
- Wilson SE, Dutra BAL, Wahabi K, J Refract Surg, 2025 -- Topical losartan in the treatment of stromal scarring after refractive surgery
- contact lens spectrum — Restoring Visual Function in a Posttraumatic Cornea
- contact lens spectrum — Fitting Multifocal Scleral Lenses For Unilateral Central Corneal Scar
- Contact Lens Spectrum — Fitting Scleral Lenses for Ocular Surface Disease
- Contact Lens Spectrum — A Scleral Lens Solution to PCED and OSD Discomfort
- Restoring Visual Function in a Posttraumatic Cornea
- Fitting Multifocal Scleral Lenses For Unilateral Central Corneal Scar
- Fitting Scleral Lenses for Ocular Surface Disease
- BostonSight PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) and Scleral Contact Lenses - EyeWiki
- Corneal Ectasia Preferred Practice Pattern® - Ophthalmology
- Prospective pilot randomized controlled study of mini-scleral lenses versus rigid gas permeable lenses in irregular cornea with dry eye | Scientific Reports
Based on findings from:
Visual Rehabilitation With a Scleral Lens in an Eye With Corneal Scarring
Maddison Fortman, OD. Contact Lens Spectrum, 2026.
https://www.clspectrum.com/supplements/2026/2026-specialty-contact-lens-case-reports/visual-rehabilitation-with-a-scleral-lens-in-an-eye-with-corneal-scarring
This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.
