12/12/2025
Typically, the main reason we consider a corneal transplant (PK) for ectatic or scarred corneas is when axial scarring reduces vision. But hereโs the catch: you cannot accurately judge the visual impact of a scar without a scleral or GP lens trial.
Why?
Because what looks like visually significant scarring may actually be optical distortion from an irregular ocular surface, not the opacity itself. A scleral lens neutralizes that distortion and reveals the eyeโs true visual potential.
Corneas with scars also tend to show elevated higher-order aberrations (HOAs), creating glare, halos, photophobia, and reduced optical quality. Research shows sclerals can significantly improve visual acuity and optical symptoms in these cases.ยน
Patient Spotlight ๐
This 45-year-old was referred after recovering from a fungal ulcer, likely caused by sleeping in a contact lens that had pollen trapped underneath.
At his first visit:
โข BCVA in glasses: 20/100
โข With a scleral lens: 20/30
โข Corneal densitometry 3 months post-healing (before image): noticeably elevated
At his annual visit today (1 year later):
โข 50% improvement in corneal densitometry (after image)
โข BCVA in scleral: 20/20 with an over-refraction
โข Comfortable, consistent visual quality with his scleral lens โจ
No transplant. No aggressive intervention.
Just healing, time, and the right optics.
ยน ๐ฆ๐บ๐๐ผรญ๐บ-๐ข๐บ๐๐๐๐, ๐ฉ. ๐พ๐ ๐บ๐
. (2024). ๐จ๐๐๐๐๐๐พ๐๐พ๐๐ ๐๐ฟ ๐ต๐๐๐๐บ๐
๐ฐ๐๐บ๐
๐๐๐ ๐๐ ๐ค๐๐พ๐ ๐๐๐๐ ๐ข๐๐๐๐พ๐บ๐
๐ฎ๐๐บ๐ผ๐๐๐ ๐บ๐๐ฝ ๐จ๐๐๐พ๐๐๐
๐บ๐๐๐๐ ๐ด๐๐๐๐ ๐ฌ๐๐๐-๐ฒ๐ผ๐
๐พ๐๐บ๐
๐ซ๐พ๐๐๐พ๐, ๐ฑ๐พ๐ ๐ฌ๐พ๐ ๐ฎ๐ฟ๐๐บ๐
๐๐๐
.
