Case report assisted and written by Jacqueline Petersen from the School of Optometry at Indiana University. Presumed graduation date of May 2025.
A 37-year-old male presented to the clinic for his first ever eye exam, reporting blurry vision over the past two years. He had a history of a herpes simplex infection and noted that his vision “has not been the same” since.
On examination, visual acuity was 20/100 in the right eye and 20/60 in the left eye. A dense, central corneal scar with extensive neovascularization was observed in the right eye. Unfortunately, vision in this eye could not be restored, necessitating a full- thickness transplant, “Penetrating Keratoplasty” (PK) which was performed at the University of Minnesota (see Photo 1).
In the left eye, a diffuse stromal opacity was noted just temporal to the line of sight. Despite this, the patient achieved 20/25 vision with the help of a scleral lens (see Photo 2).
Although the scar in the left eye appears relatively minor, its proximity to the line of sight and induction of irregular astigmatism, impacts a significant portion of vision, particularly during pupil dilation.
Scleral lenses can effectively overcome the irregular, scarred surface, providing a smoother optical interface allowing for increased acuity. This intervention resulted in a notable improvement in vision, from 20/60 to 20/25, which was transformative for the patient.
He expressed great excitement upon regaining clear vision!
