Scleral Lens Management of Paralytic Exposure Keratopathy
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By
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Angelica C. Scanzera, OD, MPH
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September 17, 2026
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4 min
Clinical Report: Scleral Lens Management of Paralytic Exposure Keratopathy
Background
Exposure keratopathy is a significant condition resulting from incomplete eyelid closure, leading to corneal damage and discomfort. Traditional management strategies may not suffice for all patients, particularly those with chronic conditions such as facial nerve palsy. Scleral lenses provide a protective fluid reservoir over the cornea, which can enhance healing and patient comfort.
Data Highlights
No numerical or trial data provided in the source material.
Key Findings
- The patient had persistent exposure keratopathy due to chronic facial nerve palsy.
- Initial management included artificial tears, ointments, and surgical interventions, which did not fully resolve symptoms.
- Fitting a scleral lens resulted in improved visual acuity to approximately 20/20 OD.
- Refinements to the scleral lens fit enhanced comfort and stability, leading to better ocular surface health.
- Scleral lenses provided sustained protection for the cornea.
Clinical Implications
Clinicians should consider scleral lenses in complex cases of exposure keratopathy.
Conclusion
This case demonstrates the effectiveness of scleral lenses in managing paralytic exposure keratopathy.
Related Resources & Content
- Rodriguez-Garcia A, et al, Surv Ophthalmol, 2025 -- The etiologic and pathogenic spectrum of exposure keratopathy: diagnostic and therapeutic implications
- Scanzera AC, et al, Case Rep Ophthalmol, 2021 -- Adjunct use of therapeutic scleral lens for exposure keratopathy after severe chemical burn
- Harthan JS, Shorter E, Clin Optom (Auckl), 2018 -- Therapeutic uses of scleral contact lenses for ocular surface disease: patient selection and special considerations
- Contact Lens Spectrum — The Scleral Lens Vault
- Contact Lens Spectrum — Fitting Scleral Lenses for Ocular Surface Disease
- Contact Lens Spectrum — DRY EYE DX AND TX
- contact lens spectrum — Preserving a Failing Penetrating Keratoplasty Graft
- Facial nerve palsy (Bell's palsy) - College of Optometrists
- Exposure Keratopathy - EyeWiki
- Lagophthalmos - StatPearls - NCBI Bookshelf
- The etiologic and pathogenic spectrum of exposure keratopathy: Diagnostic and therapeutic implications - ScienceDirect
- Eye Care in the Intensive Care Unit (ICU) | The Royal College of Ophthalmologists
- BostonSight PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) and Scleral Contact Lenses - EyeWiki
- Scleral lenses and PROSE: indications, complications, and future challenges - PMC
- Higher order aberrations and visual outcomes of scleral lenses for ocular surface disease - PubMed
- Clinical Practice Guideline for the Evaluation and Management of Facial Nerve Palsy - PubMed
- CADS as a Decision-making Tool: Developing an Oculoplastic Management Algorithm for Facial Nerve Palsy - PubMed
- Eyelid Malpositions and Ocular Surface Disease: Clinical Correlations and Management Strategies - PMC
- Facial Nerve Palsy - EyeWiki
Based on findings from:
Scleral Lens Management of Paralytic Exposure Keratopathy
Angelica C. Scanzera, OD, MPH. Contact Lens Spectrum, 2026.
https://www.clspectrum.com/supplements/2026/2026-specialty-contact-lens-case-reports/scleral-lens-management-of-paralytic-exposure-keratopathy
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.
