Scleral contact lenses for optimal visual recovery in a case of severe acid burn with total lagophthalmos

Abstract

Chemical injuries can severely damage the ocular surface. We present the case of a man in his 40s with severe periocular chemical injury with total lid loss and severe exposure keratopathy. He sustained burns to 45% of his body surface area and needed tracheostomy and multiple full-thickness skin grafts. Both eyes required surgery, Boston type 1 keratoprosthesis and penetrating keratoplasty for the right and left eye, respectively. There was melting in the right eye and a persistent epithelial defect in the left eye. Eventually, we suggested 18 mm diameter scleral contact lenses for both eyes to aid in ocular surface stabilisation. His best corrected visual acuity improved significantly with the scleral lenses to 20/100 and 20/320 in the right and left eyes, respectively. This case demonstrates that scleral lenses can treat the complications of exposure keratopathy and can improve vision. Therefore, they may be considered for rehabilitation of the ocular surface in eyes with severe chemical periocular injuries.

Contact lenses in dry eye disease and associated ocular surface disorders

“…[ 100 ] Chaudhary et al . [ 119 ] have reported successful use of ScCL in eyes with keratoprosthesis with total lid loss secondary to chemical injury and stated that ScCL can be used safely in such eyes in the interim to buy time for definitive surgical interventions.…”

Impact of Symblepharon Management With Ocular Surface Reconstruction on Scleral Lens Fitting in Eyes With Chronic Cicatrizing Conjunctivitis and Keratopathy

“…1,2 These lenses are widely used to improve visual acuity in eyes with chronic cicatrizing conjunctivitis (CCC) 3 secondary to Stevens-Johnson syndrome (SJS), [4][5][6] ocular mucous membrane pemphigoid (MMP), 7 ocular graft-vs-host disease (GVHD), 8,9 and chemical or thermal burns. 1,[10][11][12][13] In eyes with CCC and corneal scarring, owing to various degrees of coexistent dry eye disease (DED) or limbal stem cell deficiency (LSCD), optical penetrating keratoplasty may not be a feasible option. Hence, SCLs are a valuable and sustainable option for visual rehabilitation in these eyes.…”