We sat down last week with Dr. Marcussen and asked her several questions about her specialty, scleral contacts and the Gentle Vision Shaping System:
Why fit scleral contact lenses?
Scleral contacts have been shown to be the best option for people with high amounts of astigmatism, keratoconus, or any irregular cornea conditions. They are also good for people who have had refractive surgery.
I realized there was not any optometrist fitting scleral contact lenses in this region. I would go to continuing education meetings and hear speakers from the Boston Foundation for Sight talk about someone having 20/50 or worse best corrected vision with their glasses and, when they were fit in scleral lenses, they had significantly improved vision. I wanted to be able to help my patients with these same ocular issues achieve the same clear comfortable vision.
What has helped people with these conditions in the past?
Prior to scleral contact lenses, people with high corneal astigmatism had to wear hard corneal lenses. Often, however, comfort was an issue with these hard lenses. Scleral lenses are the size of a soft contact lens so they give the comfort of a soft lens but the clear, crisp vision of a hard lens.
Are these lenses more complicated to fit?
Yes. I fit these lenses by first taking a corneal topography reading which takes a map of 11,000 points on the cornea. I then design the lens with a software program that specifically matches the individual cornea to the scleral contact lens. This software program is a more complicated way to fit scleral contacts but it is a much more exact and accurate way to fit contacts. This allows for a much more exact fit allowing for crisp, clear, comfortable vision.
What is your favorite thing about fitting your patients with scleral lenses?
I have had such memorable moments since I began to fit scleral contacts. I remember on time when I first put a pair of scleral lenses on a 53 year-old woman with Keratoconus. She sat in my exam chair and the room got real quiet. She then, after several moments, spoke with a lot of emotion in her voice and said, “I haven’t seen like this since 4th grade!” I will never forget that moment.
I remember fitting a truck driver who always had trouble with his hard contacts for Keratoconus. He would get red, tired eyes that would burn from his contacts. He was refit into scleral lenses and tells me how much safer he feels on the road because now, he doesn’t feel the need to close his eyes all the time while driving to relieve discomfort.
Why are scleral contacts so comfortable?
They fit on the conjunctiva (white part) of the eye which is why they feel like a soft lens. However, they first get a solution put in them so they bathe the cornea in a smooth fluid which always makes the eye feel good! This is why they are such a great option to people with dry eyes.
Have you tried scleral contacts yourself?
Yes. When I wear contacts, I wear scleral lenses. I love the comfort of these lenses and really appreciate how much they help my dry eyes. They feel even better than soft contacts to me because they don’t dry out my eyes as much as soft lenses do.
What new advances are you working on for scleral contacts?
I am a certified Wave designer which is the program that uses the Wave software and matches the 11,000 points on the cornea to the scleral contact lens. I have a Google group of optometrists throughout the world and we are always learning and improving from each other.
Since there is no one else in our area fitting sclerals, I go to Chicago, Texas, and other places to The Vision by Design conference each year and learn from world leaders in this field.
Learning to fit scleral lenses and keeping up with all the newest advances has been very time consuming, but the rewards of really improving someone’s life has made all the time and effort very much worthwhile.