John Nesto is from Charlotte, N.C. He came to Complete Eye Care in Belmont, N.C. because he needed a solution due to complicated vision issues. John had Keratoconus in both eyes and he had a corneal graft done in his left eye to try to treat the Keratoconus. John was not able to see clearly with 
glasses because of the Keratoconus and the resulting corneal transplant.
John came in from Charlotte to see Dr. Barbara Marcussen who fit him with scleral contact lenses. Dr. Marcussen is a certified wave designer who individually designs each scleral lens for every patient she sees. She first takes a topography reading of 11,000 points on each cornea and then designs the lens to individually match all 11,000 points of John’s corneas. Since John had a corneal transplant in one eye it is very important that the lens not touch any part of the graft to ensure that there is no discomfort. Dr. Marcussen uses OCT images to measure the microns between the back surface on the scleral lens and the front surface of the cornea. This ensures a healthy graft while wearing the contact lenses.
People like John who have Keratoconus or corneal graft transplants need scleral lenses to see clearly. Keratoconus causes irregular astigmatism which cannot be corrected with traditional eyeglasses. Therefore, people who have Keratoconus do not see clearly with glasses but have much improved vision with scleral contact lenses. John had also undergone a corneal transplant and since his corneal graft caused significant visual distortion due to irregular astigmatism, he needed a scleral lens in that eye also.
A scleral lens in the safest way to correct for irregular astigmatism after a corneal graft because once a corneal transplant has been done, no part of the cornea should be touched with a contact lens. Scleral lenses are completely safe since they can be measured to ensure they vault over the cornea. This is the reason that Dr. Marcussen measured the micron distance between John’s cornea and scleral lens, to ensure with 100% accuracy that the eye with the Keratoconus was not touched by the lens. She also measured the eye with the corneal graft to make sure the transplanted cornea was not touched by the scleral lens.
John was able to achieve 20/25 vision in both the eye with Keratoconus and the eye with the corneal graft. He has clear, comfortable vision all day and is very happy with the scleral contact lenses he was fitted for at Complete Eye Care in Belmont, N.C.
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