09/03/2025
Another day, another microvault design!
This patient traveled internationally to see us, which is truly such an honor. She planned to be in Charlotte for one week and came in wearing lenses 👓 that were not fitting well, with impingement on the pinguecula both nasally and temporally, leaving her with chronically red, irritated eyes.
With the height of her pingueculae, I would have prescribed an impression- or scan-based lens. But those require at least a 3-day washout, and in her case, I would have preferred 5 days with frequent artificial tears before refitting, which was not possible with her short trip.
So, we went with 's ZenLens. ZenLens is one of my favorite sclerals. I love its flexibility in customization, the ability to add HOAs, and (importantly for her) the ability to add two microvaults.
Here’s my step-by-step for microvault design:
1️⃣ Document the hash mark location in degrees.
2️⃣ Record the start and end points of the conjunctival elevation contact with the lens in degrees and millimeters.
3️⃣ Note how far the pinguecula extends into the lens and identify the location of its apex — this helps ensure the microvault is positioned and sized precisely.
4️⃣ Document the elevation of the pinguecula. For reference, the thickness of a trial scleral lens is ~300 µm. Profilometry is great for accuracy, but anterior segment OCT works too — just make sure you measure exactly where the lens comes into contact with the pinguecula.
Give all this info to the consultation team and let them work their magic ✨