Thursday, April 6th - Wet Lab: Fitting Scleral Lenses

Wet Lab - Fitting Scleral Lenses

Co-Sponsored by the Scleral Lens Education Society

( 5.5 total hours of COPE approved CE )

Thursday April 6th, 2017

10:00 am - 5:30 pm

ROOM: crystal VII



Have you dabbled in large diameter lenses but lack enough experience to be confident in your assessment of the fit?  Then this lab is for you. Not only will you experience actual human eyeballs being fit with Scleral lenses from leading large diameter lens manufacturers but you will also have leading experts in the field handy to answer any of your questions.  The lab will also feature several short presentations on Scleral lens fitting before the actual live Wet Lab.

Session 9:  Fitting Scleral Lenses

( Session 9 - 5.5 hours of COPE approved CE ) 

Principle Instructors: Lynette Johns and Mindy Toabe, OD, FAAO, FSLS


10:00-12:00 Introduction to Scleral Lenses - Lynette Johns

12:00-1:00 Changing the Curve:  Using Toricity with Scleral Lenses - Lynette Johns

1:00-2:00 Lunch in the Exhibit Hall

2:00-4:30 Scleral Lens Education Society Workshop Basics of Scleral Lens Fitting: It's as Easy as 1-2-3 - Mindy Toabe, Karen Lee, Michael Lipson, Nathan Schramm, Jason Jedlicka, Langis Michaud

4:30-  435 BREAK

4:35 - 5:15 A word from our sponsors

Scleral Lens Education Society: Basics of Scleral Lens Fitting It’s As Easy As 1-2-3

Principal Instructor: Mindy Toabe, OD, FAAO FSLS

Co-Instructor: Karen Lee, OD, FSLS

Co-Instructor: Michael Lipson, OD, FAAO, FSLS

Co-Instructor: Nate Schramm, OD, FSLS

Co-Instructor: Jason Jedlicka, OD, FAAO, FSLS, FCLSA

Co-Instructor: Tom Arnold, OD, FSLS

Course Description

This two and a half hour presentation is an interactive, workshop format where basic principles of large diameter, rigid, scleral contact lenses are discussed.  A didactic portion is followed by hands-on practice with insertion, removal, and fitting of scleral lenses. Instructors who are Fellows of the Scleral Lens Education Society will provide hands on fitting experience using scleral lenses from several different lens companies. 

Course Learning Objectives

 To provide participants with knowledge and training of scleral contact lens fitting and management of a wide range of medical conditions. Fitting guidelines and problem solving tips can be applied to the practice of participants. Even practitioners who have never fit a scleral lens should feel comfortable starting a scleral lens practice after the workshop.


I.          History of Scleral Contact Lenses

            A.         Blown glass lenses

            B.         Molded plastic lenses

            C.         Modern gas permeable lenses

II.         Scleral Lens Terminology and Design

A.             Size classifications

B.             Lens designs and parameters

C.              Sagittal depth

D.             A Guide to Scleral Lens Fitting

III.        Scleral Lens Fitting Principles

A.             Fitting Process

1.              Completely bridge over the cornea

                                    a.         Apical clearance

                                    b.         Apical touch

                                    c.         Tear reservoir

2.              Tears over the Limbal region

                                    a.         Limbal clearance

                                    b.         Limbal compression

3.              Provide an adequate “landing” on the sclera

                                    a.         Scleral alignment

                                    b.         Vascular impingement

                                    c.         Vascular compression

4.              Ensure adequate tear flow under the lens

                                    a.         Tight periphery

                                    b.         Loose periphery

B.             Fitting Pitfalls - Don’t Do This

1.              Steep lens

2.              Flat lens

3.              Tight limbal area

4.              Excess limbal sag

5.              Loose edge

6.               Tight edge

C.              Reasons For Scleral Lens Use

 1.         Decentered keratoconus

2.         Discomfort with other lens designs  

 3.         Dislodgement of corneal rigid gas permeable lens

 4.         Advanced corneal disease and ectasia

 5.         Protection of cornea

 IV.        Case Histories

Several photographic histories will be presented and will be selected from a large collection of cases including keratoconus, penetrating keratoplasty, corneal scarring, trauma, severe dry eye, graft vs host disease, etc.

V.         Hands-On Training

A.             Cleaning and disinfection of scleral lenses

B.         Selection of base curve/vault

C.         Insertion with plunger vs finger technique

D.         Assessing fit in free space and with a slit lamp

                        1.         Bubble formation

                        2.         Vault and fluorescein evaluation

                        3.         Assessing peripheral fit (landing)

                        4.         Assessment of limbal zone

                        5.         Measuring tear flow

E.              Removal technique

                        1.         Plunger

                        2.         Hands / finger

F.              Solutions

 1.         Insertion solutions

                                    a.         non-preserved 0.9% sodium chloride solution (non-FDA approved)

                                    b.         Menicon LacriPure (FDA approved)

                        2.         Disinfection solutions

                        3.         Additional cleaners

VI.        Optical Coherence Tomography

May be used to demonstrate the fitting relationship of the scleral lens to cornea. Hands-on training of assessment of the scleral lens using optical coherence tomography on volunteer patients may be performed during the workshop.

VII.       Complications of Scleral Lens Wear

An opportunity for discussion of complications of scleral lens wear will be offered at this workshop.

Registration For This Course Includes: Scleral Lens Wet Lab, functions, meals, lectures, and exhibit hall access for, Thursday April 6th.  

Registration Does Not Include: Boot Camp for Newcomers, Vision By Design 2017 General Sessions, Scleral Lens Wet Lab, WAVE, Advanced Ortho-k, and other premium workshops or functions designated outside of Vision By Design 2017. Register for these events separately.

Meeting Refund Policy: Full refund up to one month before the meeting date* Refund requests will be accepted until March 7th, 2017 (*Minus a $50 administrative fee).