Longterm restoration of ocular surface function with scleral lenses

The ocular surface ecosystem is altered when any of its components becomes compromised. In order to have a stable and healthy ocular surface, there has to be good lid function, healthy and functioning lacrimal and accessory glands, healthy and functional limbal stem cells to allow corneal regeneration and prevention of corneal conjunctivalization, a healthy tear film, and adequate sensory innervation. Without these, the ocular surface, in particular the cornea is vulnerable to severe desiccation, vascularization, opacification, conjunctivalization, chronic epithelial breakdowns, chronic exposure, amongst other sequela; ultimately resulting in compromised vision, severe forms of pain, and light sensitivity. Scleral lenses play an important role in restoring the ocular surface function of compromised ocular surfaces, even when other topical or surgical approaches have failed. Not only are they a viable option, but they are able to provide long-term support of the ocular surface. We report on various cases where long-term restoration of ocular surface function was achieved with the use of prosthetic replacement of the ocular surface ecosystem (PROSE) treatment and use of BostonSight^® PROSE devices.