The role of scleral lens properties and solution use in midday fogging

Abstract

Purpose : Midday fogging with scleral lens wear is a poorly understood phenomenon that likely has multiple contributing factors. This study evaluated the role lens properties and solutions may play in habitual scleral lens wearers with and without midday fogging.

Methods : Habitual scleral lens wearers with 6 or more months of lens wear with their current lenses were enrolled at five sites. After completion of informed consent, data was collected on the lens material, lens coatings, diameter, and solutions used for lens storage and for filling the lenses before insertion. Indications for scleral lens wear were collected. Participants were asked if they experience midday fogging and if they removed their scleral lenses during the day. Backward regression of the lens and solution properties was conducted to determine the contribution of the factors toward midday fogging collectively and individually.

Results : Forty-eight scleral lens wearers (29 female) were enrolled. 27 reported experiencing midday fogging. 26 reported removing and reinserting the lenses during the day, although 2 of them did not report midday fogging. Thirteen (48 %) of those with midday fogging had irregular corneas (IC) and 12(44%) had ocular surface disease(OSD); the non-fogging participants were comprised of 14 (45%) with IC and 5 (24%) with OSD. Regression found that the lens properties and solutions evaluated accounted for 27.65% of the variance related to midday fogging. None of the lens properties or solutions evaluated made a significant impact upon midday fogging when considered individually.

Conclusions : The results of this study show the complexity of midday fogging, and point to the likelihood that a single change of solution use or lens properties is not likely to change midday fogging by itself, and multiple changes may be needed to make an impact.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.