Scleral Lenses for Presbyopes Struggling With Dry Eye
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By
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NICHOLAS GIDOSH, OD
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September 17, 2026
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Clinical Scorecard: Scleral Lenses for Presbyopes Struggling With Dry Eye
At a Glance
| Category | Detail |
|---|
| Condition | Dry Eye and Presbyopia |
| Key Mechanisms | Scleral lenses improve ocular surface health and visual performance. |
| Target Population | Patients with dry eye conditions and presbyopia, particularly older adults. |
| Care Setting | Optometry practice specializing in contact lens fittings. |
Key Highlights
- Scleral lenses can be customized for center-near or center-distance optics.
- Patient reported improvement in vision and resolution of dryness symptoms.
- Initial fitting showed good stability with toric multifocal optics.
- Subjective visual performance was rated higher with center-near lenses.
- Corneal health improved with reduced punctate staining after lens use.
Guideline-Based Recommendations
Diagnosis
- Assess ocular surface health and visual acuity.
- Evaluate for irregular astigmatism and other corneal conditions.
Management
- Fit scleral lenses with appropriate customization for visual demands.
- Consider additional treatments for ocular surface dryness.
Monitoring & Follow-up
- Regular follow-ups to assess lens fit and ocular health.
- Monitor for any changes in visual acuity and comfort.
Risks
- Potential for lens decentration affecting visual performance.
- Risk of corneal staining or discomfort if lenses are not fitted properly.
Patient & Prescribing Data
Older adults with a history of ocular surface issues and presbyopia.
Scleral lenses can provide significant relief from dryness and improve visual acuity.
Clinical Best Practices
- Customize lens design based on individual patient needs and ocular measurements.
- Trial different lens designs to determine patient preference.
- Incorporate surface treatments to enhance lens wetting and comfort.
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