Scleral contact lenses are the best non-surgical treatment for people with Keratoconus. However, adding this service to your practice requires significant training, equipment, and time investments. If you are interested in offering scleral lens fitting to your patients, we can help.
We believe surgery is the last resort for most Keratoconus patients because surgery to correct this disease rarely produces the desired results and also exposes the patient to all the risks attendant with any invasive surgical procedure.
Correcting Keratoconus would be much simpler if regular contact lenses could be prescribed, but keratoconic corneas have a topography that standard contact lenses cannot fit, resulting in significant eye irritation and limited vision improvement. The solution is to fit your keratoconic patients with scleral lenses, which offer the best alternative to corneal surgery, ill-fitting contact lenses, and minimally effective glasses.
From a business perspective, if you are like most general Optometrists, your practice is likely surrounded by many competing general Optometry offices, which results in two adverse effects on your business:
But offering scleral contact lenses to your patients can help you provide your patients with the best possible vision for their condition and also help you grow your practice:
You’ll need several things to become a scleral fitting specialist. The basics are:
And as you progress, you would want to add one or more of the following advanced scanning instruments:
The different scanning technologies and software produce an incredibly detailed ocular profile of your patient’s eyes, the path that the light travels, and both the front and back of their corneas. For example, the ESP scanning technology generates a topography map with as many as 350,000 individual reference points across a 20 mm diameter area. This precision enables the specialty contact lens labs, such as Bausch + Lomb’s Zenlens labs, to create exceptionally comfortable and effective scleral lenses.
We’ve discovered over the years that our cKlear Method™ for fitting scleral lenses delivers the best results for our Keratoconus patients. It’s rigorous and takes advantage of the most advanced technology available today. The cKlear Method™ has six steps (and seven when High Order Aberrations are present), which are:
Step 1: Standard Comprehensive Eye Exam – Keratoconus patients frequently have additional issues our treatment plan must address.
Step 2: cKlear Diagnostic Exam – This step gives us the first look at the patient’s cornea topography using a Nidek OPD III and other instruments.
Step 3: cKlear Preliminary Treatment Plan – Based on our examination results, we’ll discuss the next steps for the patient based on the severity of their Keratoconus and other conditions.
Step 4: cKlear Design Exam – If scleral lenses make the most sense for our patient, we make a much more detailed map of their eye topography using a variety of instruments, including the Zeiss OCT, Ovitz Ares Aberrometer, and the Eaglet ESP.
Step 5: cKlear Dispensing Visit – We analyze the fit of the custom scleral lenses, teach the patient how to use and care for them, and provide the necessary lens care products.
Step 6: Follow-up Visit – The patient will return after wearing their new scleral lenses for a few days to double-check the fit and answer any questions.
Step 7: High-Order Aberration Visit – An adjustment visit may be necessary for some patients with high-order aberrations. We check the lens fit during that visit and note the adjustments required to reduce or eliminate HOAs.
One of the benefits of the cKlear Method™, aside from providing our patients with clear vision, is a 52% first-fit success and an 85% second-fit success rates (compared to about 25% to 30% first-fit success and up to 3 or 4 visits for traditional scleral lens fitting methods). And the rates are improving every day as the technologies advance.
Many patients who could not be fit after ten or more visits by other optometrists come to us and experience a first-fit success.
The Zenlens® from Bausch + Lomb is one of our preferred scleral lenses because of the lens’s highly flexible nature and the ability to make adjustments quickly without redesigning all new lenses. Just a few of this product’s key features include:
Adding a scleral lens fitting treatment option to your practice takes time and money to obtain the equipment and software, learn how to use it, carve out dedicated space, and allocate staff time. That’s why we routinely work with general Optometry practices like yours to help you decide about adding the capability.
As part of an educational Bausch+Lomb SVP Zenlens® program, Dr. Barry Leonard, the Clinical Director and Founder of the California Keratoconus Center, speaks to eye care groups on “Achieving a successful fit using the Zenlens® scleral lens technology.”
In addition, Dr. Leonard will travel to other Optometrist offices with Bausch + Lomb Zenlens® specialists to help train you and your staff in scleral lens fitting best practices. During these half-day sessions, we ask that you schedule five or six Keratoconus patients who need scleral lenses. Dr. Leonard provides one-on-one consultation with you and your patients during the scleral lens fitting process.
There’s no cost to your practice for the training. And, to support you and your patients further, comprehensive “fit kits” are available to help ensure success with your first scleral lens treatments.
We offer two additional ways to help you get started with scleral lens fitting. First, if you want to invest in the same equipment we use at the California Keratoconus Center, Dr. Leonard can guide you to the right providers and recommend the best instruments for your practice.
Secondly, we often support other doctors who don’t yet have the training to offer scleral lenses to their patients. In these situations, we set up a co-management process where we provide the scleral lens fitting services leaving the patient in your care for all other optometry needs. Learn more about how we work with other doctors here.
Scleral lenses provide such effective relief to people with Keratoconus we encourage you to offer them to your patients. Contact the California Keratoconus Center today to discuss how to get started.