Blind World Magazine

Stevens Johnson Syndrome.
The Scleral Lens.

October 29, 2005.
India Times.

It isn't possible for an ordinary person to understand what this lens has done for me," says Sam Balasundaram. With no vision in his right eye and having already undergone a cornea transplant in his left eye, Sam was beginning to reconcile himself to a life of severely impaired vision, if not blindness.

"A second cornea transplant had only 50% chances of success. I didn't want to go blind," adds Sam. His saviour - The Boston Scleral Lens. Hyderabad-based LV Prasad Eye Institute, a leader in eye-care and research, has tied up with the Boston Foundation for Sight for the distribution of the revolutionary scleral lens.

Available only at LVPEI in India, the lens is used for treating visually-impaired patients suffering from Stevens Johnson Syndrome, keratoconus, severe dry eye, high astigmatism and other corneal afflictions hitherto considered untreatable by conventional methods.

Being a customised product, the Boston scleral lens is expensive, costing close to $3,900 in the US. "We have fitted 40 patients with this lens so far. One in every 600 patients we see needs the scleral lens. But the cost is a prohibitive factor for now," said LVPEI cornea & anterior segment consultant Dr Pravin V Krishna. However, LVPEI has been able to significantly subsidise the cost of the lens for its patients.

Developed by Dr Perry Rosenthal of The Boston Foundation for Sight, the lens is unique as it rests on the relatively less sensitive white part of the eye called the sclera and vaults over the cornea. "All contemporary lenses rest on the cornea. This causes irritation for people with diseased corneas.

The scleral lens is soothing to wear because it holds saline water in the reservoir created between the cornea and the lens, thus eliminating direct contact," added Dr Krishna. The reservoir of artificial tears also helps in lubricating the eye. The tears also flush out contaminants from the eye. A notable feature is that the tears do not contain any preservatives.

The lens has proven to be highly effective in treating people suffering from Stevens Johnson Syndrome (SJS). "SJS is generally a drug reaction that results in severe dry eye conditions. People suffering from SJS find it difficult to look at light and gradually lose their vision", said Dr. Krishna.

SJS may even be precipitated by the use of common drugs like aspirin. So far, no satisfactory medical or surgical treatment is available to rehabilitate these patients. The Boston scleral lens is made of Itafluorofocon B, a fuoro-silicone/acrylate copolymer that has high oxygen permeability. Each lens is custom-made.

The fitting procedure itself is time consuming, requiring an average of three lenses to be made per eye. The lens parameters are sent to the Boston Foundation in USA, where the customised final lens is fashioned. The entire procedure typically takes a week.

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