Reinier Stortelder is an optometrist with a degree from the University of Applied Sciences Utrecht in the Netherlands. He has more than 10 years of experience fitting contact lenses with a focus on scleral lenses, orthokeratology and soft specialty lenses in private practice. He also gained experience in corneal and refractive surgery with his focus on the preoperative imaging devices.
Scleral lenses are large diameter gas permeable lenses that by definition vault over the entire cornea and rest on the sclera / conjunctiva. Fitting sclerals requires considerable skills and experience. The fitting process of scleral lenses can be broken up into three elements:
1. Vaulting the central cornea
2. Clearing the limbus
3. Aligning the sclera
Steps 1 and 2 are fairly straightforward in most cases, but aligning the landing zone of the scleral lens to the sclera absorbs the most time. Optimal alignment is essential to achieving comfort for the lens wearer. There is also a need to create the right amount of sealing, avoiding excessive tear exchange that can lead to debris buildup while also avoiding excessive compression / blanching.