Scleral Lens Simplicity: Utilizing Anterior Segment OCT for Scleral Lens Fitting

A 26-year-old with keratoconus saw major visual improvement with scleral lenses, highlighting the benefits of anterior segment OCT in lens fitting accuracy.

By
Aubry Tackett, OD, FAAOMS
September 1, 2025
7 min

Optometric Management

Overview

This report highlights the use of anterior segment optical coherence tomography (OCT) in enhancing the accuracy of scleral lens fitting for a patient with keratoconus. The integration of OCT technology resulted in significant visual improvement and optimal lens alignment.

Background

Scleral lenses are increasingly recognized as effective tools for visual rehabilitation in patients with corneal irregularities such as keratoconus. Accurate fitting of these lenses is crucial to ensure optimal visual outcomes and patient comfort. Anterior segment OCT provides detailed imaging that aids in assessing lens fit and corneal health, thereby improving fitting success rates.

Data Highlights

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Key Findings

Anterior segment OCT significantly improved scleral lens fitting accuracy.
The patient achieved visual acuity of 20/25 with scleral lenses compared to 20/30 and 20/150 with spectacles.
Initial OCT measurements indicated adequate central clearance and limbal alignment.
Follow-up evaluations confirmed stable lens fit with no adverse effects.
OCT technology allows for precise assessment of corneal and scleral interactions during lens fitting.

Clinical Implications

The use of anterior segment OCT in scleral lens fitting can enhance visual outcomes for patients with keratoconus. Clinicians should consider integrating OCT into their fitting protocols to optimize lens alignment and patient comfort.

Conclusion

This case illustrates the effectiveness of anterior segment OCT in facilitating successful scleral lens fittings, leading to improved visual acuity and patient satisfaction. Continued use of this technology is recommended for complex cases.