Visual Rehabilitation With a Scleral Lens in an Eye With Corneal Scarring

By
Maddison Fortman, OD
September 17, 2026
4 min

Contact Lens Spectrum

Objective:

To describe the successful visual rehabilitation of a patient with corneal scarring using a scleral lens and topical losartan.

Approach:

Case Description: A 25-year-old female with keratoconus developed a bacterial corneal ulcer post-corneal cross-linking, leading to scarring and neovascularization. She was fitted with a BostonSight Scleral lens and treated with topical losartan.
Treatment Protocol: Topical losartan was administered 4 times daily, including instillation in the scleral lens reservoir to enhance drug delivery.

Key Findings:

Best-corrected visual acuity improved from hand motion to 20/20 after scleral lens wear and topical losartan use.
Scleral lens facilitated sustained exposure to topical losartan.

Interpretation:

The case describes the use of scleral lenses to improve visual acuity and deliver topical medications like losartan.

Limitations:

Topical losartan is an off-label use for reducing corneal scarring and is not FDA approved for this purpose.
No published guidelines exist for the duration of topical losartan therapy.

Conclusion:

The case highlights the potential benefits of scleral lenses in managing corneal scarring and suggests further investigation into the efficacy of topical losartan.