The Scleral Lens Vault: <br>Observing Your Fluorescein</br>
In the times of ever-advancing new technology for precise fitting of scleral lenses, has the art of diagnostic fitting fallen to the wayside
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By
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Jamie Kuzniar, OD
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September 1, 2026
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Objective:
To discuss the importance of fluorescein observation in the fitting of scleral lenses, particularly in the context of advanced fitting technologies.
Approach:
- Fluorescein Application: Fluorescein is applied to the outside of a settled scleral lens to observe tear exchange and identify misalignment.
- Assessment of Lens Fit: Overall lens fit and limbal alignment are assessed using fluorescein, focusing on centration and vaulting chamber adjustments.
Key Findings:
- Excessive tear exchange can indicate lens misalignment, leading to foggy vision.
- Adjustments to the vaulting chamber may be necessary rather than just steepening the lens.
- A dark band around the limbus suggests the need to increase the vaulting chamber or lens diameter.
Interpretation:
Fluorescein remains a critical tool in scleral lens fitting.
Conclusion:
Assessment of scleral lens fit using fluorescein can enhance patient comfort and lens performance.
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