Abstract: Scleral lenses in SJS

I find this sort of thing (90% success of SJS patients adapting to scleral lenses?!) very hopeful. One of the reasons people are so reluctant to try sclerals is that it seems counterintuitive to put a big lens in a dry eye. However, the results over the years show many people with very severe dry eye wearing them successfully. I'd really like to know how the 7 patients in this study fare a couple of years on - whether they're all wearing lenses full time.

PURPOSE:
To evaluate the efficacy of scleral contact lenses use on the management of ocular sequelae from Stevens-Johnson syndrome patients.

METHODS:
In a retrospective study, patients who suffered sequelae of Stevens-Johnson syndrome and started the use of scleral contact lenses were followed. Patients were submitted to an evaluation of symptoms through a questionnaire; ophthalmologic exam (visual acuity measurement, biomicroscopy, ocular surface staining with fluorescein drops, Schirmer test).

RESULTS:
Ten eyes of seven patients were analyzed. Visual acuity varied from hand movements to 20/25. All patients presented some degree of corneal opacity and slight symblepharon. In patients whose adaptation to scleral contact lenses was successful (90%), they all refered improvement of symptoms and sight. As for the biomicroscopic findings it was observed an improvement of conjunctival hyperemia and keratitis and a reduction of the mucous secretion in 90% the cases.

CONCLUSIONS:
A successful adaptation to scleral contact lenses was feasible on most patients, with relief of symptoms and better visual acuity, probably due to regularization of the surface. Scleral contact lenses represent an important and accessible alternative to reduce the limitations inferred by the damages from Stevens-Johnson syndrome.

Arq Bras Oftalmol. 2010 Oct;73(5):428-32.
[Scleral contact lens for ocular rehabilitation in patients with Stevens-Johnson syndrome].
[Article in Portuguese]
Siqueira AC, Santos MS, Farias CC, Barreiro TR, Gomes JÁ.
Source
Departamento de Oftalmologia, Instituto da Visão, Universidade Federal de São Paulo, SP, Brasil. anacarolinapunzi@yahoo.com.br