iSight™ Scleral Contact Lens
Corneas come in many shapes and sizes. Some so extreme that even standard gas permeable or custom soft lenses can’t correct every patient’s vision. That’s why scleral contact lenses should be a part of any specialty contact lens practice. The iSight™ Scleral contact lens from GP Specialists is designed for those extreme irregular cornea cases.
iSight™ Scleral Contact Lens – Irregular Cornea Lens Design
iSight™ Scleral contact lenses are a uniquely designed scleral lens that utilizes multiple aspheric conical curves to achieve a more natural tangential fitting zone. This unique design means that the iSight™ Scleral contact lens has the ability to vault both the cornea and limbus zone while maintaining a minimal sagittal depth that promotes good tear exchange.
Simplified approach to Fitting iSight™ Scleral Contact Lenses
Ideal scleral contact lens candidates include the following:
- Irregular Corneas
- Post Lasik Surgery Complications
- Pellucid Marginal Degeneration
- Corneal Ectasia
- Dry Eye
- Keratoplasty Patients
iSight™ Scleral Contact Lens – Available Parameters
Base Curves: 5.50 to 9.50
Power Range: -20.00 to +20.00 in .25 steps
Standard Diameter: 16.4
Available Diameter Range: 14.2 to 24.00
iSight™ Scleral Contact Lens – Multifocal Parameters
Add power range: +0.50 to +5.00
Center Distance or Center Near
Standard OZ: 1.0
Available OZ: 0.5 to 7.0
Initial iSight™ Scleral Contact Lens Base Curve Selection
We recommend two methods to establish the initial Base Curve to select.
- The first method is to select a B.C. that is 2 diopters steeper than the flat K.
- The second method is to take the Median Curve and select a lens that is one diopter steeper than the Median Curve.
- Place the lens in a DMV© Scleral Cup while applying gentle suction. Fill the cup of the lens with non-preserved saline and insert the lens as described in the insertion and removal section. Non-preserved artificial tears can also be used in lieu of saline.
- The lens should vault over the cornea approx. 150 um to 250 um.
- Pay attention to the scleral fit to be sure that there is sufficient clearance as to not cause blanching of the limbal vessels
- If bubbles form under the scleral lens, remove and reinsert the scleral lens and ensure that the bowl is completely filled with saline. If bubbles remain– the fit is too steep and a flatter B.C. should be selected
- Once you have determined the proper B.C., do an over-refraction to determine the final Rx.
iSight™ Scleral Contact Lens Scleral – Multifocal
The iSight™ Scleral Multifocal is available in both a Center Near & Center Distance design. Because we recognize that not all designs work on all patients, we have included both in the iSight™ Scleral fitting set. The fitting set includes 3 base curves in both the Center Near & Center Distance design. The iSight™ Scleral Multifocal is also a progressive design incorporating Distance /Intermediate/near vision or Near/Intermediate/Distance. The same parameters that are available in our spherical iSight Scleral contact lens design are also available in our multifocal scleral lens design.
iSight™ Scleral Contact Lens – Diagnostic Fitting Set Includes:
- 10 Spherical scleral fitting lenses
- 3 Center Near Multifocal scleral fitting lenses
- 3 Center Distance Multifocal scleral fitting lenses
- Trial set sagittal depth chart
iSight™ Scleral Contact Lens – Insertion and Removal
Inserting iSight™ Scleral Contact Lens Using A DMV® Scleral Cup™
Use a special device, called a DMV® Scleral Cup™ to support the lens for application. The application process with the DMV Scleral Cup starts by lightly squeezing the tapered handle so you create a mild suction. Carefully place the scleral lens on the top of the DMV, making sure it is centered. When the lens is centered on the DMV, stop squeezing the device. This will create a mild suction and the scleral lens should be securely positioned on the DMV Scleral Cup. Completely fill the bowl of the scleral lens with a preservative free saline and add fluorescein if desired for evaluation. Position the patient’s head parallel with the countertop, or table, and have the patient look straight down. To apply the scleral lens, you will need to separate the patient’s eyelids in order to position the sclera lens on the eye. This can be accomplished by using your free hand to pull up the upper lid while having the patient pull the bottom lid down.
Slowly move the sclera lens toward the eye and instruct the patient to look directly at the black dot formed by the hole in the DMV Scleral Cup. Gently apply the lens directly on the eye and over the pupil. Once the sclera contact lens is on the eye, a light squeeze of the tapered handle will release the sclera lens from the DMV Scleral Cup. Release the lids and have the patient blink several times to clear the excess fluid. The lens will automatically center. Wash the DMV Scleral Cup frequently in warm soapy water and let air dry.
Important note about removing scleral contact lenses
Because of the capillary forces associated with large diameter lenses, it is important NOT to attempt to remove a scleral lens by pulling from the center. This can create negative pressure making it difficult to remove the lens.
Removing the iSight™ Scleral Lens With The DMV© 45™
The DMV 45 is an excellent tool to remove scleral lenses for both practitioner and patient. The DMV 45 has a 45-degree angle which keeps the fingers out of the line of sight while removing the scleral lens.
Pull the lower lid away from the cornea to expose the lower edge of the lens. Hold the handle of the DMV 45 and carefully place the device on the lower edge of the scleral lens. Once the DMV 45 is adhered to the scleral lens, gently pull the lens away from the eye. If the lens is difficult to remove, apply gentle pressure to the scleral to release the capillary pressure.
With the lens resting on the DMV 45, gently move the sclera lens off the device using your thumb and index finger.
iSight™ Scleral Contact Lens – Consultation
Fitting iSight™ Scleral contact lenses will add another dimension to your practice. The learning curve is not steep and can be mastered with just one or two patients. Our consultants stand ready to assist you in any way we can to make your experience a memorable one for both you and your patient.