Therapeutic and ocular surface indications for scleral contact lenses

Contrary to popular perception, the large size and scleral bearing surface of scleral contact lenses (ScCLS) can be beneficial in the management of certain ocular surface disorders. They can provide retention of a precorneal tear reservoir for corneal hydration with total protection from the external environment and from the lid margins and lashes. They can relieve pain, prevent exposure keratitis, and enhance epithelial healing. The use of ScCLs is limited in large part by ophthalmologists' perception of excessive complexity. Actually, while some cases are challenging, many are straightforward. This review summarizes indications for therapeutic use of ScCLs and describes techniques and considerations that contribute to their clinical success.