Beyond Correction: Debunking Custom Soft Lens Myths & Integrating Mental Health in Keratoconus Care – Scleral Lens Summit Recap
Debunking Custom Soft Lens Myths – Summary
This lecture by Dr. Susan Resnick challenges common misconceptions surrounding custom soft lens fitting and emphasizes that, with accurate measurements and thoughtful design, these lenses are more accessible and practical than many assume.
Clinical Indications:
Comfort issues with conventional lenses—custom lenses tailor sagittal depth using HVID, corneal curvature, and eccentricity, plus material characteristics like modulus, water content, and oxygen permeability for optimal centration and movement.
Refractive complexities: high ametropia, unstable vision in high toricity, irregular corneas (ectasia, post-refractive surgery, post-graft), and vertical binocular imbalances.
Anatomical/physiological factors: pupil size variations, conjunctival irregularities (e.g., blebs, patches, pterygia), dry eyes (dictating material choice), and palpebral aperture issues (too large for scleral designs).
Special applications: presbyopia optimization (custom zones/adds, angle kappa adjustment, astigmatism control), myopia management (center-distance multifocals that correct cylinder and tailor optics for peripheral defocus), and prosthetic/cosmetic uses (tints for corneal scarring, iris anomalies, or diplopia).
Myths Addressed:
You must be a contact lens specialist.
You need multiple fitting sets.
You must use only silicone hydrogels.
There isn’t sufficient patient demand.
Myth-Busters:
Custom soft lens fitting is very similar to standard fitting techniques.
Empirical fitting is straightforward—based on reliable measurements like K values, corneal diameter, refraction, and pupil size.
Available materials meet corneal oxygen needs adequately.
Patients value precision and comfort; they respond positively to “custom care.”
Key Takeaways:
Custom soft lens fitting is feasible and beneficial for a wide patient population.
Empirical data drives the process—no need for lots of hardware or specialized training.
Material options are sufficient to support eye health.
Practices can stand out by offering custom lenses and improving patient satisfaction.
Check out the full presentation at WooU.org under “Past Events”!
Beyond Correction – Integrating Mental Health and Functional Outcomes in the Management of Keratoconus
This presentation by Dr. Kriti Bhagat emphasizes that keratoconus care extends far beyond visual correction. Dr. Bhagat explores not only the clinical pathology of keratoconus—chronic, progressive corneal thinning and irregular astigmatism—but also the often-overlooked psychological and quality-of-life ramifications of the disease.
She highlights that patients frequently experience anxiety, depression, loneliness, and identity challenges triggered by diagnosis and visual fluctuation. Notably, despite relatively preserved visual acuity, keratoconus patients may report the worst emotional and functional well-being compared to other ocular diseases.
Dr. Bhagat outlines a comprehensive care “roadmap”:
Early intervention and patient/family education about genetic risk and cross-linking referrals
In-office and ongoing support that includes mental health considerations
Incorporating coping strategies like mindfulness-based therapy, behavioral activation, relaxation techniques, journaling, peer support groups, and neurofeedback tools
Office protocols that train staff to recognize and respond to emotional distress and guide patients toward holistic care
Key Takeaways:
Keratoconus affects patients emotionally, even when vision seems stable.
Successful care should integrate visual correction and mental well-being.
Implement early screening, counseling, and multidisciplinary support.
Staff education and patient mentorship programs reinforce long-term resilience.
Check out the full presentation at WooU.org under “Past Events”!
Scleral Lens Summit – Combined Session Summary
The Scleral Lens Summit featured two complementary lectures, bringing together leading experts to highlight both the latest innovations and the practical realities of scleral lens care.
In Shaping the Future: Advances in Scleral Lenses, Dr. Jamie Kuzniar and Dr. Jason Jedlicka reviewed how profilometry and wavefront-guided optics are transforming scleral lens practice. They emphasized how advanced imaging enables custom haptics, quadrant-specific adjustments, and higher-order aberration correction—reducing chair time while improving first-fit success and visual performance for patients with irregular corneas.
In Scleral Lens Troubleshooting, Dr. Brooke Messer and Dr. Zac Holland provided a systematic approach to overcoming common fitting challenges. From clearance and scleral landing issues to decentration, residual astigmatism, and end-of-day discomfort, the session equipped attendees with practical tools to address vision, fit, and comfort complications efficiently.
Summit Takeaways:
Profilometry and HOA correction are shaping the next generation of scleral lens design.
Careful assessment of scleral anatomy and alignment is key to safe, effective fitting.
A structured troubleshooting framework improves outcomes and long-term comfort.
Check out the full Scleral Lens Summit presentations at WooU.org under “Past Events”!
