Case Report: Remote Scleral Lens Fitting for High Toric Scleras in a Keratoconus Patient.

SIGNIFICANCE: Technology plays a crucial role in customizing scleral lenses and improving lens alignment, especially in challenging scleral shapes. In addition, remote fitting technology allows optometrists to extend their expertise globally, empowering patients to access to customized lenses without travel expenses. PURPOSE: The objective of this study was to document the difficulties encountered in fitting a scleral lens in a patient with keratoconus and pronounced scleral toricity. In addition, the study aimed to present the successful remote fitting achieved by using advanced technology. CASE REPORT: An Irish male patient diagnosed with keratoconus exhibited high scleral toricity. Generally, keratoconus eyes often exhibit significant scleral asymmetry associated with cone decentration and disease severity. Improperly aligned scleral lenses can lead to regional changes in scleral shape, lens decentration, discomfort, and visual disturbances. Indeed, previous scleral lens fits were unsuccessful because of these issues. Corneoscleral profilometry was acquired in Ireland and then used in Italy to design customized lenses, which were then delivered to the patient's optometrist in Ireland. The first lenses designed and delivered demonstrated excellent overall performance without requiring adjustments. CONCLUSIONS: This report highlights the importance of corneoscleral profilometry to increase efficiency and reduce lens reorders and chair time, and the remote fitting in overcoming barriers to accessing specialized lens fitting.

Impact on refractive surgery due to increasing use of personal protection equipment: Insights from EUROCOVCAT group.

Since the World Health Organization declared COVID-19 to be a pandemic on 11th March 2020, changes to social and sanitary practices have included significant issues in access and management of eye care during the COVID-19 pandemic. Additionally, the fear of loss, coupled with social distancing, lockdown, economic instability, and uncertainty, have led to a significant psychosocial impact that will have to be addressed. In the current COVID-19 pandemic, personal protective equipment such as face masks or face coverings have become a daily necessity. While "mass masking" along with hand hygiene and social distancing became more widespread, new issues began to emerge - particularly in those who wore spectacles as a means of vision correction. As we began to see routine patients again after the first lockdown had been lifted, many patients visited our clinics for refractive surgery consultations with a primary motivating factor of wanting spectacle independence due to the fogging of their spectacles as a result of wearing a mask. In this article, we report on new emerging issues in eye care due to the widespread use of masks and on the new unmet need in the corneal and cataract refractive surgery fields.