Under (Scleral Lens) Pressure

A recent study published in Ophthalmic and Physiological Optics has investigated the effects of scleral lens wear on intraocular pressure (IOP) by analyzing changes in the Bruch’s membrane opening–minimum rim width (BMO-MRW). The research focused on patients with keratoconus, a condition marked by corneal ectasia and collagen abnormalities, which may predispose individuals to optic nerve vulnerability.

The study, conducted by researchers from Université de Montréal, Canada, followed a randomized and unmasked design, examining keratoconus patients who had been fitted with scleral lenses for over three months. The authors employed optical coherence tomography (OCT) to measure BMO-MRW at two-hour intervals over six hours, both with and without scleral lenses.

Their results reveal that wearing scleral lenses caused significant thinning of the BMO-MRW after six hours, compared to negligible changes observed in participants not wearing lenses. The authors noted that this significant thinning could potentially be correlated with increased IOP during lens wear, presenting a possible risk to optic nerve health, especially in patients already at risk of glaucomatous neuropathy.

The study findings highlight the need for close monitoring of IOP and optic nerve health in keratoconus patients using scleral lenses, particularly over extended periods. And while the findings are compelling, the authors emphasize the need for larger long-term studies in order to validate these results and assess potential long-term risks of scleral lens wear.