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Ellen Shorter, Jennifer Fogt, Muriel Schornack, Amy Catherine Nau, Jennifer Harthan, Kimberly Patton, Cherie B Nau; Indication for Scleral Lens Wear and Fogging in Established Wearers. Invest. Ophthalmol. Vis. Sci. 2022;63(7):552 – A0250.
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© ARVO (1962-2015); The Authors (2016-present)
Scleral lenses (SLs) are fit to support the ocular surface in patients with dry eye disease as well as to improve vision in patients with irregular corneal astigmatism or refractive error. Individuals wearing SLs may complain of lens fogging requiring SL removal and reapplication throughout the day. The purpose of this study was to report indication(s) for SL wear, subjective fogging, mid-day SL removal and reapplication, and clinician observed findings of front surface non-wetting and presence of posterior fluid reservoir (FR) debris.
Patients who had worn their current SLs for a minimum of 6 months were recruited from 5 sites. After obtaining informed consent, data was collected on patient demographics, indication for SL wear, subjective complaint of fogging, and if SLs were removed and reapplied mid-day. In addition, clinicians recorded the presence or absence of front surface non-wetting, mucus debris, particulate debris, and posterior FR haze.
There were 30 patients enrolled with the following indications for SL wear: corneal irregularity (63.3%), dry eye disease (23.3%), refractive error (10%), and other (3.3%). Slightly more than half complained of lens fogging (56.7%) with 60% reporting removing and reapplying their lenses mid-day. Of those with subjective fogging 94.1% reported routinely removing and reapplying lenses mid-day compared to only 15.4% of those without fogging complaints. Clinicians observed SL front surface non-wetting in 34.5% (10/29 eyes) of patients with fogging complaints and only 4.2% (1/24 eyes) of those without. Particulate debris was noted in 58.6% (17/29 eyes) of those with subjective fogging and 25% (6/24 eyes) of those without which was observed more frequently than mucus debris (10/29 foggers vs 1/24 non fogger eyes) and haze (10/29 fogger vs 0/24 non fogger eyes).
In this series of established SL wearers, most patients with subjective fogging routinely remove and reapply their lenses mid-day. Symptoms described as “fogging” may arise from either front surface non-wetting or post-lens FR debris.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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