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Global health: Health in vulnerable communities
Scleral contact lenses for optimal visual recovery in a case of severe acid burn with total lagophthalmos
  1. Simmy Chaudhary1,2,
  2. Subhajit Chatterjee2,
  3. Neha Jain1 and
  4. Sayan Basu1,3
  1. 1The Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
  2. 2Bausch and Lomb Contact Lens Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
  3. 3Prof. Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Sayan Basu; sayanbasu{at}lvpei.org

Abstract

Chemical injuries can severely damage the ocular surface. We present the case of a man in his 40s with severe periocular chemical injury with total lid loss and severe exposure keratopathy. He sustained burns to 45% of his body surface area and needed tracheostomy and multiple full-thickness skin grafts. Both eyes required surgery, Boston type 1 keratoprosthesis and penetrating keratoplasty for the right and left eye, respectively. There was melting in the right eye and a persistent epithelial defect in the left eye. Eventually, we suggested 18 mm diameter scleral contact lenses for both eyes to aid in ocular surface stabilisation. His best corrected visual acuity improved significantly with the scleral lenses to 20/100 and 20/320 in the right and left eyes, respectively. This case demonstrates that scleral lenses can treat the complications of exposure keratopathy and can improve vision. Therefore, they may be considered for rehabilitation of the ocular surface in eyes with severe chemical periocular injuries.

  • Eye
  • Anterior chamber

http://dx.doi.org/10.1136/bcr-2021-248384

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    Footnotes

    • Contributors SChau drafted and edited the manuscript. SChat helped in data collection and managing the patient. NJ helped in editing reviews on acid attacks and different aspects of the victims. SB finalised the manuscript and assumes full responsibility for the case report.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests The authors' institute is the sole distributor of BostonSight SCLERAL (BSS) and PROSE lenses in South Asia and South-East Asia.

    • Provenance and peer review Not commissioned; externally peer reviewed.