Scleral Lenses and Irregular Corneas: Patient versus Practitioner Goals

For more than 25 years, my clinical care for the most part has involved providing vision care for individuals with Keratoconus and other types of irregular cornea. What I have come to appreciate is that what the patient seeks to achieve is often very different from what we as eye care providers are looking to accomplish.

First and foremost, individuals who have learned that they suffer from some sort of corneal irregularity that has begun to interfere with their vision, are simply seeking to address that very issue, their vision. Their other concern is that they are not “going to go blind” from the condition. They don’t think about how the selection and application of a vision care correction might adversely affect their future ocular health.

Rheumatoid keratolysis a silent complication associated with Rheumatoid arthritis

A 34 year old women suffering from rheumatoid arthritis since 20 years had a complaint of blurred vision in right as she had a problem of corneal melting.  It has been stabilised bytreatment followed by regular monitoring that arthritis was in-active on etanercept.But right cornea revealed 3mm descemetocle, later tectonic corneal transplantation was done and was prescribed tacrolimus. The histological examinations done after three years was characterised by complete loss of corneal stroma due to rheumatoid keratolysis. It has been indicated that metalloproteinase are active in RA are involved in Keratolysis.

Get PDF Link Here