Understanding Wavefront Guided Scleral Lenses: A Comprehensive Guide

CLEI has pioneered some of the most significant advancements in vision correction technology. One such advancement is the integration of wavefront technology into scleral lenses. Wavefront technology, originally developed for astronomy, has revolutionized the way eye care professionals can assess and correct visual aberrations. By applying this technology to scleral lenses to further enhance the optics of scleral lenses, many patients with complex corneas have been able to enjoy a clearer vision and better quality of life. 

What Are Scleral Lenses?

Scleral lenses are specialized contact lenses designed to address a variety of eye conditions. Categorically, scleral lenses are used to improve vision for those with irregular corneas, most commonly keratoconus, and aid in healing for those affected by those with severe ocular surface diseases, most commonly severe dry eye disease. 

Unlike conventional contact lenses that sit directly on the cornea, scleral lenses vault over the cornea and align with the sclera and overlying conjunctiva (white of the eye). The gap between the cornea and the back side of the lenses is filled with saline creating a liquid-filled reservoir. 

When it comes to complex corneas, scleral lenses are an excellent option that should be considered before a patient is referred for corneal transplantation. They offer several advantages over traditional contact lenses. First, their larger size ensures stability on the eye, reducing the risk of dislodgement or discomfort. Secondly, the space between the back surface of the lens and the cornea acts as a reservoir for a saline solution, which has dual benefits: first there is no physical contact with the cornea and its extremely sensitive nerves allowing for improved comfort and second, the liquid reservoir provides constant hydration to the cornea, which can aid individuals with dry eyes. Lastly, their gas-permeable material allows oxygen to reach the cornea, maintaining eye health.

Advancing Scleral Lenses with Wavefront Technology

Scleral lenses have greatly benefitted countless patients, however, for some patients the quality of their vision, even with the scleral lenses, falls short of their expectations. These patients may experience visual aberrations such as halos and glare, flares, starbursts, smearing, overlapping, ghosting, or seeing multiple images, even while wearing their scleral lenses. If that has been your experience, it doesn’t mean your vision can’t be improved. Wavefront guided scleral lenses may be able to optimize the quality of your vision.

Understanding Wavefront Technology in Ophthalmology

Interestingly, wavefront technology was developed for astronomy to capture clearer images of distant stars and planets. With wavefront technology, we use a device called a wavefront aberrometer to measure these distortions (aberrations) in the eye and create a three-dimensional “wavefront map.” 

How does it work? 

Projected light travels through the eye, reflects off the retina, and bounces back, creating an outgoing wavefront. We then measure the distortions in the outgoing wavefront and compare them to the incoming beam, which gives us precise measurements of aberrations in the eye, including higher order aberrations (HOAs). HOA’s are responsible for visual quality. 

With a detailed map of these HOAs, we can understand the nuances of an eye’s optics and thus visual performance, and can better address complex vision issues.  

Wavefront Guided Scleral Lenses: How Do They Work?

Prescribing wavefront guided scleral lenses is a multi-step process. Once a stable, well-fit scleral lens with basic optics is achieved, we then use the OVITZ xwave technology to measure your eye’s unique optics while you wear the scleral lens. Detailed data about the eye’s focusing power across the pupil, as well as the light distortion you see, is used to create a wavefront map.

Next, we use the wavefront map as a blueprint to create high performance, HOA reducing optics. The resulting wavefront guided scleral lenses are highly customized and fit the unique optical properties of your eyes. It’s a personalized solution that can reduce higher order aberrations to improve contrast sensitivity, visual acuity, and overall visual quality. Dr. John Gelles has pioneered the use of this technology in clinical practice, running clinical trials and presenting the results to doctors around the world. As a leader in wavefront guided scleral lenses, you can rest assured that your sight is in good hands, regardless of the complexity of your vision issues.

Who Can Benefit from Wavefront Guided Scleral Lenses?

Wavefront guided scleral lenses can make a huge difference for individuals with complex vision issues. In our experience, many patients with conditions like keratoconus, corneal disease or trauma, and post-LASIK complications find that wavefront guided scleral lenses give them a quality of vision traditional scleral lenses can’t offer.

What kind of improvement can patients expect from Wavefront Guided Scleral Lenses? 

The extensive research conducted here at CLEI, has shown nearly all patients have a reduction in HOA with these lenses but it is variable how much improvement will be achieved. On average, patients experience a 50% reduction of HOA and one to two lines of vision improvement. Nearly all patients, approximately 97%, prefer their vision with wavefront guided scleral lenses when compared to traditional scleral lenses. 

Conclusion

If you have been struggling with halo, glare, flare, streaking, smearing, ghosting, doubling while wearing traditional scleral lenses or other contact lenses, wavefront guided scleral lenses may be the answer to your problems. By integrating wavefront technology into scleral lenses, our doctors can address higher order aberrations to improve quality of vision and provide personalized visual correction. They can even significantly improve a patient’s night vision. To learn more about how wavefront guided scleral lenses can benefit you personally, schedule a consultation with us today.

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